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Allergic fungal sinusitis and eosinophilic mucin rhinosinusitis: diagnostic criteria

Published online by Cambridge University Press:  13 August 2013

N Uri
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Lady Davis Carmel Medical Center, Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
O Ronen
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Lady Davis Carmel Medical Center, Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
T Marshak
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Lady Davis Carmel Medical Center, Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
O Parpara
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Lady Davis Carmel Medical Center, Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
M Nashashibi
Affiliation:
Department of Pathology, Lady Davis Carmel Medical Center, Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
M Gruber*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Lady Davis Carmel Medical Center, Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
*
Address for correspondence: Dr Maayan Gruber, Department of Otolaryngolgy – Head and Neck Surgery, Lady Davis Carmel Medical Center, 7 Michal St, Haifa 34362, Israel E-mail: maayan_gr@yahoo.com

Abstract

Background:

Chronic sinusitis is one of the most common otolaryngological diagnoses. Allergic fungal sinusitis and eosinophilic mucin rhinosinusitis can easily be misdiagnosed and treated as chronic sinusitis, causing continuing harm.

Aim:

To better identify and characterise these two subgroups of patients, who may suffer from a systemic disease requiring multidisciplinary treatment and prolonged follow up.

Methods:

A retrospective, longitudinal study of all patients diagnosed with allergic fungal sinusitis or eosinophilic mucin rhinosinusitis within one otolaryngology department over a 15-year period.

Results:

Thirty-four patients were identified, 26 with eosinophilic mucin rhinosinusitis and 8 with allergic fungal sinusitis. Orbital involvement at diagnosis was commoner in allergic fungal sinusitis patients (50 per cent) than eosinophilic mucin rhinosinusitis patients (7.7 per cent; p < 0.05). Asthma was diagnosed in 73 per cent of eosinophilic mucin rhinosinusitis patients and 37 per cent of allergic fungal sinusitis patients.

Conclusion:

Allergic fungal sinusitis and eosinophilic mucin rhinosinusitis have the same clinical presentation but different clinical courses. The role of fungus and the ability to confirm its presence are still problematic issues, and additional studies are required.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2013 

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