Socioeconomic factors in allergic fungal rhinosinusitis with bone erosion

Previous studies have shown an increase in the incidence of orbital and skull base erosion in African Americans and males diagnosed with allergic fungal rhinosinusitis (AFRS). However, underlying reasons for the advanced presentation of AFRS in certain ethnic and gender groups are currently unknown. We evaluated several socioeconomic and demographic factors for their possible contribution to advanced presentation of AFRS in our patient population. Such factors have not been examined previously in the literature. The aim of this study was to evaluate the contribution of race, ethnicity, and various socioeconomic factors to the advanced presentation of AFRS with orbital and skull base bone erosion.

Retrospective review of medical records and radiological studies were performed for 54 consecutive AFRS patients presenting to a tertiary care rhinology practice. Presence of radiological evidence of bone erosion was compared with demographic data and insurance status, as indicated in the medical record. Bone erosion status was evaluated also against state demographic data, divided by county.

Males were significantly more likely to present with bone erosion than females (p = 0.009). In this analysis, age and race were not statistically associated with the presence of bone erosion. Additionally, no statistically significant correlations were identified between bone erosion and several socioeconomic factors listed from the patient's county of residence (percentage below the poverty level, median household income, population percentage of African Americans, or number of physicians per 1000 residents).

No socioeconomic factors were identified that correlated with the incidence of bone erosion in patients diagnosed with AFRS. Factors other than socioeconomic status and access to health care appear to play a role in the advanced presentation of AFRS.