The Role of CT Scan and Histopathology in Diagnosis of Allergic Fungal Sinusitis (original) (raw)
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Diagnostic Accuracy of Computed Tomography by Fungal Sinusitis: A Case-control Study
INTERNATIONAL JOURNAL OF ANATOMY RADIOLOGY AND SURGERY
Introduction: Recent decades show a considerable increase in fungal infections, hence can lead to fungal sinusitis. Immunosuppression, post organ transplant, diabetes mellitus, and Human Immunodeficiency Virus (HIV) infection have led to a rise in the incidence of fungal infections. Recent advances in nasal endoscopy, Computed Tomography (CT), and Histopathological Examination (HPE) Techniques have led to better detection of fungal aetiology. Aim: To determine the most significant CT findings in fungal sinusitis or combination of findings in comparison to HPE. Materials and Methods: This retrospective case-control study was done at Sri Manakula Vinayagar Medical College and Hospital, Puducherry from January 2017 to December 2020. Total number of patients were 90. Total 50 cases of fungal sinusitis confirmed with histopathological confirmation and available non contrast CT Paranasal Sinus (PNS) images where time interval between CT and Functional Endoscopic Sinus Surgery (FESS) not e...
Annals of African Medicine, 2014
Objective: The purpose of this study was to analyze the computed tomography (CT) features of fungal sinusitis and to correlate them with nasal endoscopy and histopathological findings. Materials and Methods: Our study included 16 patients of either sex and any age group who presented in the otorhinolaryngology clinic at our hospital and had evidence of definite sinonasal disease on clinical evaluation. Multidetector CT was carried out on Somatom definition AS + 128 slice CT Machine by Siemens Germany Ltd. Axial sections were performed with the plane of data acquisition parallel to the hard palate and slice thickness of 3 mm, reconstructions at 0.75 mm in coronal and sagittal planes. Scanning parameters included 190 mA S, 120 KV and tube rotation time of 0.5 s. Provisional CT diagnosis was made in all cases and correlated with nasal endoscopy and histopathological findings. Results: Out of total 16 patients, 12 showed immunocompromised status and had infection with mucormycosis. Out of 12, 9 patients (75%) showed extension of disease beyond the sinonasal cavities and 4 (33.3%) showed evidence of bone destruction. All patients with candidiasis showed soft-tissue attenuation with hyperdense areas on CT scan. Nearly, 66.6% patients with aspergillosis showed soft-tissue attenuation with hyperdense areas and expansion of sinonasal cavities. Fifteen patients (93%) were proved to be of fungal sinusitis on histopathology. One patient of non-specific granulomatous infection showed bone destruction and mimicked fungal sinusitis on CT. Conclusions: In the present study, fungal sinusitis could be correctly diagnosed on CT with high accuracy. Thus, understanding the different CT findings of fungal sinusitis allows the radiologist to play a crucial role in the diagnosis and prompt treatment.
Presentation and diagnosis of allergic fungal sinusitis
Journal of Ayub Medical College, Abbottabad : JAMC
Allergic fungal sinusitis (AFS) is a form of fungal disease that has recently been considered a distinct clinicopathologic entity. Other forms of fungal sinusitis include acute-fulminant (invasive), chronic indolent (invasive) and mycetoma (non-invasive). Objectives were to assess the presentation and to describe the diagnostic techniques for allergic fungal sinusitis in our setup. Descriptive study was conducted in the Department of ENT and Head & Neck Surgery, Khyber Medical College and Khyber Teaching Hospital, Peshawar from January 2002 to April 2008. Twenty-three cases of allergic fungal sinusitis (ASF) were selected for the study. Data like, name, age, sex, address, clinical features, labs (Eosinophil count) and imaging studies (CT and/or MRI) were recorded, including the pre- and postoperative treatment, operative findings and postoperative results, recurrence of disease were also recorded. Surgical procedures were performed on all cases followed by medical treatment. Study r...
European Journal of Health Sciences
Purpose: To evaluate fungal sinusitis on computed tomography and its correlation with endoscopy and histopathology findings.Methodology: A comparative cross sectional analytical study was conducted at a tertiary care in Lahore. During four months of research period 138 patients were observed. CT scan was performed routinely on 128 slice CT machine by Siemens Germany Ltd having slice thickness of 3 mm, reconstructions at 0.75 mm in coronal and sagittal planes. Scanning parameters included 190 mA , 120 KV and tube rotation time of 0.5 s. Preoperative evaluation by CT was mandatory for all patients undergoing functional endoscopic sinus surgery (FESS).The findings of endoscopy and histopathology were also collected in all those cases when the investigation was done. The data was then analysis by using SPSS version 25.Findings: Out of 138 patients, 63 females and 75 males were observed. 80 were affected unilaterally (58%) and 58 were affected bilaterally (42%). 111 patients showed sinus...
A Radiological Profile of Fungal Sinusitis
Asian Journal of Pharmaceutical and Clinical Research
Objectives: To create a radiological profile of fungal sinusitis and determine the radiological differences between fungal and nonfungal sinusitis based on the presence of hyperattenuation, bony erosion, neo-osteogenesis, air-fluid level, and extrasinus extension.Methods: This is a retrospective, single-blind, case-control study involving the analysis of 119 computed tomography (CT) scans of the paranasal sinuses. Based on the histopathology, they were divided into cases comprising fungal sinusitis and controls of nonfungal sinusitis. Benign and malignant tumors and previously operated cases of fungal sinusitis were excluded from the study. The principal investigators were blinded to the diagnosis. The comparison parameters were hyperattenuation, the presence of air-fluid level, bone erosion, neo-osteogenesis, and extrasinus extension. Data was analyzed by Chi-square and Fischer exact t-test using SPSS 14.0 software and a p…
Imaging Features of Invasive and Noninvasive Fungal Sinusitis: A Review1
RadioGraphics, 2007
Fungal sinusitis was once considered a rare disorder but is now reported with increasing frequency throughout the world. The classification of fungal sinusitis has evolved in the past two decades, and this entity is now thought to comprise five subtypes. Acute invasive fungal sinusitis, chronic invasive fungal sinusitis, and chronic granulomatous invasive fungal sinusitis make up the invasive group, whereas noninvasive fungal sinusitis is composed of allergic fungal sinusitis and fungus ball (fungal mycetoma). These five subtypes are distinct entities with different clinical and radiologic features. The treatment strategies for the subtypes are also different, as are their prognoses. An understanding of the different types of fungal sinusitis and knowledge of their particular radiologic features allow the radiologist to play a crucial role in alerting the clinician to use appropriate diagnostic techniques for confirmation. Prompt diagnosis and initiation of appropriate therapy are essential to avoid a protracted or fatal outcome.
The Diagnosis and Incidence of Allergic Fungal Sinusitis
Mayo Clinic Proceedings, 1999
Objective: To reevaluate the current criteria for diagnosing allergic fungal sinusitis (AFS) and determine the incidence of AFS in patients with chronic rhinosinusitis (CRS). • Methods: This prospective study evaluated the incidence of AFS in 210 consecutive patients with CRS with or without polyposis, of whom 101 were treated surgically. Collecting and culturing fungi from nasal mucus require special handling, and novel methods are described. Surgical specimen handling emphasizes histologic examination to visualize fungi and eosinophils in the mucin. The value of allergy testing in the diagnosis of AFS is examined. AFS = allergic fungal sinusitis; CRS = chronic rhinosinusitis; CT = computed tomographic; IgE = immunoglobulin E; RAST = radioallergosorbent test From the Department of Otorhinolaryngology (
Role of CT (Computed Tomography) in the Evaluation of Fungal Diseases in Paranasal Sinus
Journal of Bangladesh College of Physicians and Surgeons, 2014
A cross sectional study carried out with patients having suspected paranasal sinus (PNS) mass during January 2009 to October 2010 to evaluate the fungal diseases in PNS by computed tomographic(CT) image and comparison of the findings of this modality with histopathological result. Among the total 76 patients, the mean age of the patients was 35.95 ± 18.24 and common complaints of the patients were nasal obstruction (73.7%) and maximum 53.9% patients had PNS mass in maxillary sinuses. Out of all cases 10 were diagnosed as having fungal infection/mass by CT scan and confirmed by histopathological evaluation. Two cases were diagnosed as having fungal infection/mass by CT scan but not confirmed by histopathological findings. Of 64 cases of other than fungal infection/mass, which were diagnosed by CT scan, six were confirmed as having fungal infection/mass and 58 were other than having fungal infection/mass by histopathology. Sensitivity of CT scan to diagnose fungal infection/mass was 6...
Presentation and management of allergic fungal sinusitis
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2007
To assess the presentation of allergic fungal sinusitis and describe the line of management in our setup. Descriptive study. Study was conducted in Otorhinolaryngology Department, Dow Medical College and Civil Hospital, Karachi, from January 2004 to January 2005. Culture and sensitivity / fungal stain proven 20 cases of allergic fungal sinusitis were selected for the study, irrespective of age and gender. Data including age, gender, socioeconomic status, signs, symptoms, laboratory findings (especially Immunoglobulin E and eosinophil count) and imaging studies (Computed Tomography and /or Magnetic Resonance Imaging) were noted for the study. Pre and postoperative medical treatment, surgery performed, follow-up; residual/recurrence disease and revised surgery performed were also recorded. In this series, allergic fungal sinusitis was a disease of younger age group with an average age of 20.75 years with male dominance (70%). Poor socioeconomic status (80%), allergic rhinitis (100%) a...