Alamoudi Hanin A, Alzabidi Samaher, Bukhari Afnan F, Zawawi Faisal
Otolaryngology - Head & Neck Surgery, King Abdulaziz University, Jeddah, SAU.
Otolaryngology - Head and Neck Surgery, King Abdulaziz University Hospital, Jeddah, SAU.
Cureus. 2022 Nov 1;14(11):e30984. doi: 10.7759/cureus.30984. eCollection 2022 Nov.
Background Allergic fungal rhinosinusitis (AFRS) is a hypersensitive response to fungi within the sinus cavity. Children represent a challenging group of patients with sinonasal disorders, as their sinus anatomy is not fully developed. This study aimed to determine the various clinical manifestations and management outcomes in children with AFRS. Methods A retrospective chart review of children who underwent sinus surgery for AFRS at a tertiary healthcare center between 2005 and 2021 was performed. Demographics, clinical manifestations, radiological and laboratory results, treatment regimens, complications, and recurrence rates were collected. Subanalysis was performed based on age at first surgery: group A (<13 years) and group B (≥13 years). Results Overall, 35 children underwent sinus surgery for AFRS during the study period. The mean patient age at the time of surgery was 14 years. Bilaterality was present in 15/35 (42.9%) patients and anosmia in 12/35 (34.3%). Polyps on examination were present in 31/35 (88.6%) patients and proptosis in 8/35 (22.9%). Sub-analysis revealed that group A showed less bilateral disease (11.4%) than group B (31.4%) and a lower Lund-Mackay score (median=11.50 and 17, respectively, p=0.002). Conclusion Age at surgery did not have an impact on the outcome. A high index of suspicion should be exercised when dealing with children with sinonasal symptoms that do not respond to routine treatment and should be investigated for chronic sinusitis.
背景 变应性真菌性鼻-鼻窦炎（AFRS）是鼻窦腔内对真菌的一种超敏反应。儿童是鼻窦疾病患者中具有挑战性的群体，因为他们的鼻窦解剖结构尚未完全发育。本研究旨在确定AFRS患儿的各种临床表现及治疗结果。方法 对2005年至2021年在一家三级医疗中心因AFRS接受鼻窦手术的儿童进行回顾性病历审查。收集人口统计学资料、临床表现、影像学和实验室检查结果、治疗方案、并发症及复发率。根据首次手术时的年龄进行亚分析：A组（<13岁）和B组（≥13岁）。结果 总体而言，在研究期间有35名儿童因AFRS接受了鼻窦手术。手术时患者的平均年龄为14岁。15/35（42.9%）的患者为双侧病变，12/35（34.3%）的患者有嗅觉丧失。检查发现31/35（88.6%）的患者有息肉，8/35（22.9%）的患者有眼球突出。亚分析显示，A组的双侧病变（11.4%）少于B组（31.4%），Lund-Mackay评分更低（中位数分别为11.50和17，p=0.002）。结论 手术年龄对治疗结果没有影响。在处理对常规治疗无反应的鼻窦症状儿童时，应保持高度怀疑，并对慢性鼻窦炎进行调查。
