Department of Otolaryngology, West Virginia University, Morgantown, West Virginia.
Department of Otolaryngology, Medical College of Georgia, Augusta University, Augusta, Georgia.
Am J Rhinol Allergy. 2021 Sep;35(5):574-577. doi: 10.1177/1945892420978725. Epub 2020 Dec 6.
The pathophysiology of allergic fungal rhinosinusitis (AFRS) is not well understood.
To study the incidence of sinonasal anatomic variants (AVs) in AFRS.
Retrospective cohort study. Patients with AFRS presenting to our clinic from 2008 to 2018 were reviewed for laterality of the disease. Patients with unilateral involvement were further studied for AV presence by reviewing their preoperative sinus CT scan at original presentation. Each patient's uninvolved side served as its own control. AVs studied include agger nasi (AN), Haller's cells (HC), concha bullosa (CB) and supraorbital ethmoid cells (SOEC).
A total of 155 patients with AFRS were identified. 30 patients (19.3%) had unilateral disease involvement. Of these, 16 patients had left sided and 14 patients had right sided disease. AV were present in 26 of the 30 AFRS sides (86.7%) and in 21 of the 30 healthy sides (70%), (chi squared = 2.45, p = 0.117). CB were present in 12 of 30 AFRS sides (40%) and only in 1 of 30 healthy sides (3%), (chi squared = 11.88, p = 0.0006). The presence of HC was more common in the AFRS vs healthy sides (7 of 30, 23.3% vs 2 of 30, 6.7%, respectively, p = 0.071). AN and SOEC presence was similar in both AFRS and healthy sides (p = 0.598 and p = 0.718 respectively).
AV are more common on the sides with AFRS compared to healthy sides, with the presence of CB reaching unquestionable statistical significance. Further study is needed to determine the possible association of AV, especially concha bullosa, with the pathophysiology of AFRS.
变应性真菌性鼻鼻窦炎（AFRS）的病理生理学尚不清楚。
研究 AFRS 中鼻-鼻窦解剖变异（AVs）的发生率。
回顾性队列研究。对 2008 年至 2018 年在我院就诊的 AFRS 患者的疾病侧别进行了回顾性分析。对单侧受累的患者，通过回顾其初次就诊时的鼻窦 CT 扫描，进一步研究其 AV 存在情况。每位患者的未受累侧作为自身对照。研究的 AV 包括额隐窝（AN）、Haller 细胞（HC）、泡状鼻甲（CB）和眶筛气房（SOEC）。
共确定了 155 例 AFRS 患者。30 例（19.3%）有单侧疾病受累。其中 16 例为左侧，14 例为右侧。30 例 AFRS 侧中 26 例（86.7%）存在 AV，30 例健康侧中 21 例（70%）存在 AV（卡方检验=2.45，p=0.117）。30 例 AFRS 侧中 12 例（40%）存在 CB，而 30 例健康侧中仅 1 例（3%）存在 CB（卡方检验=11.88，p=0.0006）。与健康侧相比，AFRS 侧的 HC 更为常见（30 例中 7 例，23.3% vs 30 例中 2 例，6.7%，p=0.071）。AFRS 侧和健康侧的 AN 和 SOEC 存在情况相似（p=0.598 和 p=0.718）。
与健康侧相比，AFRS 侧的 AV 更为常见，CB 的存在具有无可置疑的统计学意义。需要进一步研究以确定 AV，特别是泡状鼻甲，与 AFRS 病理生理学之间的可能关联。
