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第七章:变应性真菌性鼻-鼻窦炎。

Chapter 7: Allergic fungal rhinosinusitis.

机构信息

Applied Medical Research Center, St Vincent’s Hospital and University of New South Wales, and Macquarie University, Darlinghurst, Sydney, New South Wales, Australia.

出版信息

Am J Rhinol Allergy. 2013 May-Jun;27 Suppl 1:S26-7. doi: 10.2500/ajra.2013.27.3891.

DOI:10.2500/ajra.2013.27.3891
PMID:23711035
Abstract

Allergic fungal rhinosinusitis (AFRS) is a type of chronic rhinosinusitis in which patients classically exhibit nasal polyps, type I IgE-mediated hypersensitivity, characteristic findings on computed tomography scans, eosinophilic mucin, and positive fungal stain. New research has sought to further understand the pathophysiology of AFRS. However, this has also led to debate about the classification and predominance of this interesting disease process. Historically, patients with AFRS are immunocompetent. The disease is most prevalent in the southeast and south central United States and typically presents with sinus pressure, hyposmia, and congestion. Radiographically, cases of AFRS have a distinct appearance, often exhibiting unilateral heterogeneously dense material, which may erode and expand the paranasal sinus bony walls. Treatment typically consists of surgery, sinonasal irrigations, and topical and systemic steroids, all with the effort to decrease the fungal load and antigenic response. Immunotherapy is also often included in the treatment regimen for AFRS.

摘要

变应性真菌性鼻鼻窦炎(AFRS)是一种慢性鼻鼻窦炎,患者通常表现为鼻息肉、I 型 IgE 介导的过敏反应、计算机断层扫描的特征性表现、嗜酸性黏蛋白和真菌染色阳性。新的研究试图进一步了解 AFRS 的病理生理学。然而,这也引发了关于这种有趣疾病过程的分类和主导地位的争论。从历史上看,AFRS 患者的免疫功能正常。这种疾病在美国东南部和中南部最为常见,通常表现为鼻窦压力、嗅觉减退和充血。放射学上,AFRS 病例具有独特的外观,常表现为单侧不均匀致密物质,可侵蚀和扩张鼻窦骨壁。治疗方法通常包括手术、鼻内冲洗以及局部和全身类固醇治疗,所有这些方法的目的都是减少真菌负荷和抗原反应。免疫疗法也常被包括在 AFRS 的治疗方案中。

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