Background: Allergic fungal rhinosinusitis (AFRS) was first reported as a distinct clinical disorder in 1976. AFRS is defined largely by the presence of allergic fungal mucin, which is a thick, tenacious, eosinophilic secretion with characteristic histologic findings There is no convincing evidence for clinical improvement of CRS with anti-fungal therapy. The fungi causing AFRS have a great diversity. This study aimed to assess presentation of AFRS in patients with sinonasal polyposis.
Patients and methods: This prospective study was carried out in OLR-HNS Department, Zagazig University on 36 patients having sinonasal polyposis scheduled for functional endoscopic sinus surgery. All patients were subjected to full history taking, general and local examinations, routine preoperative laboratory and radiological assessments,assessment of Total IgE level and removal of the nasal polypi with microbiological study and histopathological examination for fungal elements.
Results: 13.9% of the studied patients show positive fungal stain.80% of them show Aspergillus Fumigates on fungal culture while 20% show Candida Albicans. 80% of the patients diagnosed with AFRS were from rural areas. 72.2% of the studied patients had allergy. IgE levels in AFS patients ranged between 572.10 – 623.10 IU/ml while those in patients with polyposis only ranged between 191.20 – 381 IU/ml. Most of the studied patients presented with mild polyp, thick mucopurulant discharge and had total opacification in all sinuses and obstructd OMC.
Conclusion: Diagnosing AFRS in patients with sinonasal polyposis could improve the outcome of surgery and reduce the recurrence rate by proper treatment postoperatively.