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Related Experiment Videos

Allergic fungal sinusitis

J B Kinsella1, J J Bradfield, W K Gourley

  • 1Department of Otolaryngology, University of Texas Medical Branch, Galveston, USA.

Clinical Otolaryngology and Allied Sciences
|October 1, 1996
PubMed
Summary
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Allergic fungal sinusitis, a non-invasive condition, often requires surgery. Post-operative systemic steroids may help prevent disease recurrence, warranting further clinical trials for fungal sinusitis treatment.

Area of Science:

  • Otolaryngology
  • Allergy Immunology
  • Mycology

Background:

  • Allergic fungal sinusitis (AFS) is a non-invasive fungal infection of the paranasal sinuses.
  • First described in the early 1980s, AFS presents diagnostic and therapeutic challenges.
  • Dematiaceous fungi are frequently implicated in AFS cases.

Purpose of the Study:

  • To review the clinical experience with allergic fungal sinusitis at a tertiary care center.
  • To evaluate surgical outcomes and the role of post-operative systemic steroids in preventing recurrence.

Main Methods:

  • Retrospective review of 25 patients diagnosed with allergic fungal sinusitis.
  • Surgical treatment included endoscopic techniques (17 patients) and combined endoscopic/external approaches (8 patients).

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  • Histopathological analysis confirmed the absence of tissue invasion in all cases.

    • Main Results:

    • No histological evidence of tissue invasion was found, despite extensive skull base destruction in four patients.
    • Recurrent disease occurred in 8 of 15 patients with >6 months follow-up; none had received post-operative systemic steroids.
    • Of the 7 patients who remained disease-free, 4 had received post-operative systemic steroids.

    Conclusions:

    • Allergic fungal sinusitis is a non-invasive disease, even with significant bony destruction.
    • Post-operative systemic steroid use may be associated with a lower rate of disease recurrence.
    • Clinical trials are needed to confirm the efficacy of systemic steroids in preventing AFS recurrence.