Two Cases of Allergic Fungal Sinusitis with Differing Postoperative Course

Abstract

Allergic fungal sinusitis (AFS) often develops in unilateral paranasal sinuses, which must be differentiated from tumors. When AFS develops on both sides, however, it must be differentiated from eosinophilic chronic sinusitis with evident eosinophilic infiltration at nasal/paranasal sinus mucosa; both conditions are highly recurrent and commonly considered intractable paranasal sinusitis. Surgical correction is the primary treatment method for AFS, as it is essential to connect the paranasal sinus communication to ensure exhaustive resection of the pathologic mucosa and for nasal steroids to reach each paranasal sinus. We recently encountered two AFS cases with differing postoperative courses. Case 1 showed evident exacerbation in the computed tomography findings, which suggests progression to eosinophilic sinusitis. Case 2 showed a benign prognosis without recurrence. Close long-term follow-up should be mandatory after surgery for the treatment of AFS.

Study to Determine the Incidence of Allergic Fungal Sinusitis among Patients with Nasal Polyps and Its Related Risk Factors

“…The subsequent inflammation causeobstacle of the orifices, which can be aggravated by certain anatomical factors, such as a distorted cartilage of the septal septum, and turbinate hypertrophy. As a result, media are preferred for fungal growth with obstruction of the sinus opening [8][9] . Thus, with increased exposure to antigens, this cycle results in the formation of allergic mucin, a material that seals the affected sinuses of a patient with AFS.…”