The Rate and Predictors of Allergic Fungal Rhinosinusitis Recurrence Post-sinus Surgery: A Retrospective Cohort Study

ObjectivesChronic rhinosinusitis (CRS) is the persistent inflammation of the mucosal lining of the paranasal sinuses (PNS). By definition, the inflammatory process persists beyond 12 weeks. One of its subtypes is allergic fungal rhinosinusitis (AFRS), which has a high risk of recurrence, leading to...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2023-08, Vol.15 (8), p.e43398-e43398
Main Authors: Alfattani, Naif, Alqurashi, Abdulmohsen S, Kabli, Abdulrahman F, Haji, Aseel, Alharthi, Bassam T, Mandili, Ammar K
Format: Article
Language:English
Subjects:
Allergy/Immunology
Asthma
Cohort analysis
Diabetes
Endoscopy
Family/General Practice
Hypothyroidism
Medical imaging
Otolaryngology
Polyps
Regression analysis
Rhinitis
Sinuses
Sinusitis
Steroids
Surgery
Surgical outcomes
Tomography
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Summary:ObjectivesChronic rhinosinusitis (CRS) is the persistent inflammation of the mucosal lining of the paranasal sinuses (PNS). By definition, the inflammatory process persists beyond 12 weeks. One of its subtypes is allergic fungal rhinosinusitis (AFRS), which has a high risk of recurrence, leading to revision surgery. This study aimed to establish the predictive factors for the recurrence of AFRS in post-sinus surgery patients.MethodsThis single-center retrospective study was conducted in Al-Noor Specialist Hospital, Makkah, Saudi Arabia. The charts of patients with AFRS who underwent surgery in our rhinology clinic between 2000 and 2020 were reviewed.ResultsAmong the 116 patients included in this study, approximately half (53%) were female, with a median age of 24.5 years. Thirty-nine (33.6%) patients had recurrence post-sinus surgery, with 33.3% occurring within six months of follow-up. The results showed that patients with coexisting bronchial asthma were three times more likely to experience recurrence (adjusted odds ratio {AOR}, 3.43; confidence interval {CI}, 1.35-8.71), patients with uncorrected deviated nasal septum (DNS) were three times more likely to experience symptoms again following surgery (AOR, 3.70; CI, 1.14-12.02), and patients who presented with concomitant sinus headaches are 66% less likely to experience recurrence (AOR, 0.34; CI, 0.13-0.86).ConclusionThe results showed that 33.62% of patients experienced recurrence following surgery. Bronchial asthma and DNS were strongly associated with recurrence; however, their presence does not always imply the need for additional surgery.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.43398