Julka Balpreet Singh, Patil Sanjay B, Chandrakiran C
Department of ENT and Head and Neck Surgery, M.S Ramaiah Medical College, Bangalore, Karnataka India.
Indian J Otolaryngol Head Neck Surg. 2023 Apr;75(Suppl 1):1041-1046. doi: 10.1007/s12070-023-03572-0. Epub 2023 Feb 27.
To study the incidence and prevalence of fungal sinusitis and its variants in cases of chronic rhinosinusitis in department of ENT and Head and Neck surgery. The study group consisted of 100 patients of chronic rhinosinusitis attending the outpatient and inpatients in department of Otorhinolaryngology. History was taken and diagnostic nasal endoscopy was performed. Patients underwent endoscopic sinus surgery and systemic treatment when required. Pre surgery serum IgE and post-surgery Histopathology was sent. Out of 100 patients, Males > Females and median age was 45.50 years (range 34.25-59.25 years). On DNE, 88% had polyps with 88.1% males and 87.8% females in their respective groups. 47% had allergic mucin with 49.2% males and 43.9% females in their respective groups. 34% had discharge with 28.8% males and 41.5% females in their respective groups. 37% had fungal filaments with 37.3% males and 36.6% females in their respective groups. 26% had fungal sinusitis in our study among which 53.8% were males and 46.1% were females. Peak fungal sinusitis was in 3rd to 5th decade. Commonest organism isolated was Aspergillus. Serum IgE was higher in patients with fungal sinusitis and nasal polyposis. In conclusion, the proportion of patients with Fungal Sinusitis was 26% among 100 patients with chronic rhinosinusitis. We isolated Aspergillus as the predominant fungus followed by Biporalis and Mucorales genus. Serum IgE was higher in patients with fungal sinusitis and Nasal polyposis. Both immunocompromised and competent individuals were managed surgically and/or medically when required. Our study showed that early fungal sinusitis detection leads to better management practices and prevents its progression into more severe disease with complications.
为研究耳鼻喉头颈外科慢性鼻窦炎病例中真菌性鼻窦炎及其变体的发病率和患病率。研究组由100例在耳鼻喉科门诊和住院的慢性鼻窦炎患者组成。采集病史并进行诊断性鼻内镜检查。患者在需要时接受鼻内镜鼻窦手术和全身治疗。术前送检血清IgE，术后送检组织病理学检查。100例患者中，男性多于女性，中位年龄为45.50岁（范围34.25 - 59.25岁）。在鼻内镜检查中，88%有息肉，其中男性组为88.1%，女性组为87.8%。47%有过敏性黏蛋白，其中男性组为49.2%，女性组为43.9%。34%有分泌物，其中男性组为28.8%，女性组为41.5%。37%有真菌丝，其中男性组为37.3%，女性组为36.6%。在我们的研究中，26%有真菌性鼻窦炎，其中53.8%为男性，46.1%为女性。真菌性鼻窦炎的发病高峰在30至50岁。分离出的最常见病原体是曲霉菌。真菌性鼻窦炎和鼻息肉患者的血清IgE较高。总之，100例慢性鼻窦炎患者中真菌性鼻窦炎患者的比例为26%。我们分离出曲霉菌作为主要真菌，其次是双孢霉属和毛霉目属。真菌性鼻窦炎和鼻息肉患者的血清IgE较高。免疫功能低下和正常个体在需要时均接受手术和/或药物治疗。我们的研究表明，早期发现真菌性鼻窦炎可导致更好的管理措施，并防止其发展为更严重的伴有并发症的疾病。
