Characteristics of bony erosion in allergic fungal rhinosinusitis

Objectives: Erosion of bone with or without extension of disease into adjacent anatomic spaces is observed among some patients with allergic fungal rhinosinusitis (AFRS). The objective of this report is to further define these findings as they relate to this disease. Study design: Retrospective char...

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Bibliographic Details
Published in:Otolaryngology-head and neck surgery 2001-02, Vol.124 (2), p.150-154
Main Authors: Nussenbaum, Brian, Marple, Bradley F., Schwade, Nathan D.
Format: Article
Language:English
Subjects:
Bone Resorption - diagnosis
Bone Resorption - microbiology
Ethmoid Sinus - diagnostic imaging
Ethmoid Sinus - microbiology
Ethmoid Sinus - surgery
Frontal Sinus - diagnostic imaging
Frontal Sinus - microbiology
Frontal Sinus - surgery
Humans
Maxillary Sinus - diagnostic imaging
Maxillary Sinus - microbiology
Maxillary Sinus - surgery
Mycoses - complications
Mycoses - microbiology
Retrospective Studies
Rhinitis, Allergic, Perennial - diagnosis
Rhinitis, Allergic, Perennial - microbiology
Rhinitis, Allergic, Perennial - surgery
Severity of Illness Index
Sinusitis - diagnosis
Sinusitis - microbiology
Sinusitis - surgery
Sphenoid Sinus - diagnostic imaging
Sphenoid Sinus - microbiology
Sphenoid Sinus - surgery
Tomography, X-Ray Computed
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Summary:Objectives: Erosion of bone with or without extension of disease into adjacent anatomic spaces is observed among some patients with allergic fungal rhinosinusitis (AFRS). The objective of this report is to further define these findings as they relate to this disease. Study design: Retrospective chart review of 142 patients with AFRS diagnosed using the Bent-Kuhn criteria. All patients were treated at a single institution. Results: Approximately 20% of patients with AFRS demonstrated bone erosion on CT scan. The ethmoid sinus was the most commonly eroded site. The orbit and anterior cranial fossa were the most common adjacent anatomic spaces to exhibit disease extension. Sinus expansion, not the specific organism identified, was associated with the presence of bone erosion. Surgical management with endoscopic techniques was successful for all patients without any major perioperative complications. Conclusion: Bone erosion can be related to AFR. Recognition of this possibility is important because bone erosion can be interpreted as an indication of invasive pathosis. In the presence of bone erosion or disease extension, endoscopic techniques can be used to surgically manage this disease.
ISSN:0194-5998
1097-6817
DOI:10.1067/mhn.2001.112573