对于单侧变应性真菌性鼻-鼻窦炎患者，对侧未受累侧的合适处理方法是什么？
What is appropriate management for the contralateral uninvolved side in unilateral allergic fungal rhinosinusitis?
作者信息
Bitner Benjamin F, St John Maie A, Kennedy David W, Kuan Edward C
机构信息
Department of Otolaryngology-Head and Neck Surgery, University of California Irvine Medical Center, Orange.
Jonsson Comprehensive Cancer Center.
出版信息
Curr Opin Otolaryngol Head Neck Surg. 2023 Feb 1;31(1):53-56. doi: 10.1097/MOO.0000000000000859. Epub 2022 Nov 15.
PURPOSE OF REVIEW
The aim of this article is to review the current literature regarding development of new or recurrent inflammation of uninvolved contralateral sinuses in unilateral allergic fungal rhinosinusitis (AFRS) and discuss management strategies.
RECENT FINDINGS
AFRS is a subtype of chronic rhinosinusitis with nasal polyposis (CRSwNP) that can manifest as either unilateral or bilateral disease. Particular to AFRS compared with other CRSwNP subtypes is the high propensity for recurrence. Multiple recent studies have evaluated the recurrence rate of uninvolved contralateral sinuses in unilateral AFRS and demonstrated eventual involvement of the nondiseased side. Additionally, postoperative medical therapy of the nondiseased side reduced recurrence rates overall.
SUMMARY
Recurrence of AFRS is high in both the ipsilateral and contralateral sinuses. Upfront bilateral medical and/or surgical treatment of patients presenting with unilateral AFRS may be considered to improve long-term inflammatory control.
综述目的
本文旨在回顾目前关于单侧变应性真菌性鼻-鼻窦炎（AFRS）中未受累对侧鼻窦新发炎或复发性炎症的发展的文献，并讨论管理策略。
最新发现
AFRS是慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）的一种亚型，可表现为单侧或双侧疾病。与其他CRSwNP亚型相比，AFRS的一个特别之处在于复发倾向较高。最近的多项研究评估了单侧AFRS中未受累对侧鼻窦的复发率，并证明了未患病侧最终会受累。此外，对未患病侧进行术后药物治疗总体上降低了复发率。
总结
AFRS在同侧和对侧鼻窦中的复发率都很高。对于单侧AFRS患者，可考虑早期进行双侧药物和/或手术治疗，以改善长期炎症控制。
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