Marfani M S, Jawaid M A, Shaikh S M, Thaheem K
Department of Otorhinolaryngology-Head and Neck Surgery, Dow University of Health Sciences, Dow Medical College and Civil Hospital, Karachi, Pakistan.
J Laryngol Otol. 2010 Feb;124(2):161-5. doi: 10.1017/S0022215109991253. Epub 2009 Dec 3.
Allergic fungal rhinosinusitis is a benign, noninvasive sinus disease related to hypersensitivity to fungal infection having bony skull base and orbital erosion as common finding.
This descriptive study was conducted at the department of otorhinolaryngology, Dow University of Health Sciences, Karachi, Pakistan, from April 2003 to March 2006. In forty-seven proven cases of allergic fungal sinusitis the following information was recorded: demographic data, signs and symptoms, laboratory investigation results, imaging results, pre- and post-operative medical treatment, surgery performed, follow up, and residual or recurrent disease. The Statistical Package for the Social Sciences version 10.0 software was used for data analysis.
Findings indicated that allergic fungal rhinosinusitis usually occurred in the second decade of life (51.06 per cent) in males (70.21 per cent), allergic rhinitis (100 per cent) and nasal polyposis (100 per cent). Nasal obstruction (100 per cent), nasal discharge (89.36 per cent), postnasal drip (89.36 per cent), and unilateral nasal and paranasal sinus involvement (59.57 per cent) were significant features. Aspergillus (59.57 per cent) was the most common aetiological agent. Combined orbital and skull base erosion was seen in 30.04 per cent of cases, with male preponderance 6.8:1. Endoscopic sinus surgery was performed in all cases, and recurrent or residual disease was observed in 19.14 per cent.
Allergic fungal rhinosinusitis is a disease of young, immunocompetent individual. Skull base and orbital erosion are seen in one-third of cases. Bone erosion is 6.8 times more common in males than females. Orbital erosion is 1.5 times more common than skull base erosion. Endoscopic surgical debridement and drainage combined with topical steroids leads to resolution of disease in the majority of cases, without resorting to systemic antifungal agents, craniotomy or dural resection.
变应性真菌性鼻-鼻窦炎是一种良性、非侵袭性鼻窦疾病，与真菌感染超敏反应相关，常见表现为骨质颅底和眼眶骨质侵蚀。
本描述性研究于2003年4月至2006年3月在巴基斯坦卡拉奇道健康科学大学耳鼻喉科进行。在47例确诊的变应性真菌性鼻窦炎病例中，记录了以下信息：人口统计学数据、体征和症状、实验室检查结果、影像学结果、术前和术后治疗、所施行的手术、随访以及残留或复发性疾病。使用社会科学统计软件包第10.0版软件进行数据分析。
研究结果表明，变应性真菌性鼻-鼻窦炎通常发生于男性（70.21%）的第二个十年（51.06%），伴有变应性鼻炎（100%）和鼻息肉（100%）。鼻塞（100%）、流涕（89.36%）、鼻后滴漏（89.36%）以及单侧鼻腔和鼻窦受累（59.57%）是显著特征。曲霉菌（59.57%）是最常见的病原体。30.04%的病例出现眼眶和颅底联合骨质侵蚀，男性优势比为6.8:1。所有病例均行鼻内镜鼻窦手术，19.14%观察到复发或残留疾病。
变应性真菌性鼻-鼻窦炎是一种发生于免疫功能正常的年轻人的疾病。三分之一的病例可见颅底和眼眶骨质侵蚀。骨质侵蚀在男性中比女性常见6.8倍。眼眶骨质侵蚀比颅底骨质侵蚀常见1.5倍。鼻内镜手术清创和引流联合局部使用类固醇激素可使大多数病例的疾病得到缓解，无需使用全身抗真菌药物、开颅手术或硬脑膜切除术。
