Alsaleh Majd A, Almomen Ali A
Department of Otorhinolaryngology, Aljabr Eye and ENT Hospital, Alhassa 36422, Saudi Arabia.
Department of Otorhinolaryngology, King Fahad Specialist Hospital, Dammam 32253, Saudi Arabia.
J Surg Case Rep. 2024 Nov 16;2024(11):rjae697. doi: 10.1093/jscr/rjae697. eCollection 2024 Nov.
Allergic fungal rhinosinusitis (AFRS) stands out as the predominant form of fungal sinusitis, primarily attributable to a hypersensitive response to fungal invasion. AFRS Characterized by symptoms of rhinosinusitis. The expanding mass in the disease leads to bony restructuring and implicating adjacent anatomical structures. AFRS may extend beyond the sinus cavities, leading to compression of nearby structures like the orbit, optic and abducens nerves which leads to many complications such as nerve palsies and proptosis. Diagnosis of AFRS typically necessitates radiographic assessment initially, with histopathological examination serving as the confirmatory modality. The management of AFRS typically entails a multifaceted approach integrating surgical intervention alongside medical therapy. This case report illustrates a distinctive manifestation of abducens nerve palsy secondary to allergic fungal sinusitis which had dramatic improvement and resolution of the diplopia after the Endoscopic sinus surgery. Steroids and nasal saline irrigation have been prescribed post operatively to prevent the recurrence.
变应性真菌性鼻-鼻窦炎(AFRS)是真菌性鼻窦炎的主要形式,主要归因于对真菌侵袭的超敏反应。AFRS以鼻-鼻窦炎症状为特征。该病中的肿物不断扩大导致骨质重塑,并累及相邻解剖结构。AFRS可能会超出鼻窦腔范围,导致压迫附近结构,如眼眶、视神经和外展神经,从而引发许多并发症,如神经麻痹和眼球突出。AFRS的诊断通常首先需要进行影像学评估,组织病理学检查作为确诊手段。AFRS的治疗通常需要采取多方面方法,将手术干预与药物治疗相结合。本病例报告说明了变应性真菌性鼻窦炎继发外展神经麻痹的一种独特表现,在内镜鼻窦手术后复视得到显著改善并消失。术后已开具类固醇和鼻腔盐水冲洗处方以预防复发。