Almomen Ali, Al-Enzi Omar, Alshammari Reem, Molani Fadel, Alshakhs Abdullah A, Al Ameer Mohammed A, Alarim Raghad A, Alfalah Mohammed A, Marhoon Jenan A
King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia.
College of Medicine, Northern Borders University, Arar, Saudi Arabia.
J Surg Case Rep. 2022 Oct 21;2022(10):rjaa564. doi: 10.1093/jscr/rjaa564. eCollection 2022 Oct.
Allergic fungal rhinosinusitis (AFRS) is counted as the most common form of fungal sinusitis. It is mainly due to the hypersensitivity reaction to fungal infection. Usually, the patients are atopic or immunocompetent. These patients are usually suffering from signs and symptoms of rhinosinusitis. The expanding mass in the disease leads to bony remodeling and the involvement of adjacent structures. When allergic mucin involves the orbit, many complications may occur. This includes diplopia, telecanthus, unilateral proptosis, malar flattening, epiphora, Asthenopia and even visual loss. The diagnosing of AFRS initially requires radiographic imaging, but to confirm the diagnosis, histopathological examination is needed. The treatment of AFRS should be combined with surgical and medical therapy. This case report demonstrates a unique and rare presentation of the non-invasive AFRS with bilateral proptosis which had dramatic improvement and resolution after we managed it with endoscopic sinus surgery, steroids and nasal saline irrigation.
变应性真菌性鼻-鼻窦炎（AFRS）被认为是真菌性鼻窦炎最常见的形式。它主要是由于对真菌感染的超敏反应所致。通常，患者为特应性或免疫功能正常者。这些患者通常有鼻-鼻窦炎的体征和症状。该疾病中不断增大的肿物会导致骨质重塑及相邻结构受累。当变应性黏液累及眼眶时，可能会出现许多并发症。这包括复视、睑裂增宽、单侧眼球突出、颧骨扁平、溢泪、视疲劳甚至视力丧失。AFRS的诊断最初需要影像学检查，但要确诊则需要组织病理学检查。AFRS的治疗应结合手术和药物治疗。本病例报告展示了非侵袭性AFRS伴双侧眼球突出这种独特且罕见的表现，在我们采用鼻内镜鼻窦手术、类固醇和鼻腔生理盐水冲洗进行治疗后，病情得到了显著改善并得以缓解。
