European Archives of Oto-Rhino-Laryngology

, Volume 270, Issue 12, pp 3095–3098

The prevalence of allergic fungal rhinosinusitis in sinonasal polyposis

  • Mehdi Bakhshaee
  • Mohammad Fereidouni
  • Morteza Nourollahian Mohajer
  • Mohammad Reza Majidi
  • Farahzad Jabbari Azad
  • Toktam Moghiman
Rhinology

Abstract

Allergic fungal sinusitis (AFS) is a noninvasive form of fungal rhinosinusitis with a prevalence of 6–9 % among all rhinosinusitis cases requiring surgery. The fungi causing AFRS have a great diversity and regional variation in the incidence of AFS has been reported worldwide. The aim of this study was to evaluate the prevalence of AFS among rhinosinusitis patients in the north east of Iran. In a prospective cross-sectional study 127 patients with sinonasal polyposis who were candidates for surgery were recruited. All cases were evaluated by sinonasal CT scan, Prick test for common regional allergens, total serum immunoglobulin E (IgE) level, and allergic mucin culture for fungi in suspected cases. Data analyses were done using SPSS version 13.0. Their mean age was 37.4 ± 11.6 years, the male-to-female ratio was 69/58. Eleven patients (9.45 %) met the AFS criteria. Nine cases had a positive culture for Aspergillus specimen and three for Alternaria. Prick test was positive for at least one allergen in 28 cases (22.05 %). The most common allergen was weed. The total IgE level was significantly higher in AFS patients. This study showed the prevalence of AFS among patients with nasal polyposis to be 9.45 %.

Keywords

Allergy Allergic fungal sinusitis Aspergillus Nasal polyp Rhinosinusitis 

References

  1. 1.
    Safirstein B (1976) Allergic bronchopulmonary aspergillosis with obstruction of the upper respiratory tract. Chest 70:788–790PubMedCrossRefGoogle Scholar
  2. 2.
    Glass D, Amedee RG (2011) Allergic fungal rhinosinusitis: a review. Ochsner J 11(3):271–275PubMedGoogle Scholar
  3. 3.
    Bent JP 3rd, Kuhn FA (1994) Diagnosis of allergic fungal sinusitis. Otolaryngol Head Neck Surg 111(5):580–588PubMedCrossRefGoogle Scholar
  4. 4.
    Katzenstein AL, Sale SR, Greenberger PA (1983) Allergic Aspergillus sinusitis: a newly recognized form of sinusitis. J Allergy Clin Immunol 72(1):89–93PubMedCrossRefGoogle Scholar
  5. 5.
    Fokkens WJ, van Drunen C, Georgalas C, Ebbens F (2012) Role of fungi in pathogenesis of chronic rhinosinusitis: the hypothesis rejected. Curr Opin Otolaryngol Head Neck Surg 20(1):19–23PubMedCrossRefGoogle Scholar
  6. 6.
    Asero R, Bottazi G (2000) Hypersensitivity to molds in patients with nasal polyposis: a clinical study. J Allergy Clin Immunol 105:186–188PubMedCrossRefGoogle Scholar
  7. 7.
    Solomon WR (1999) Pollens and fungi. In: Allergy ME (ed) Principles and practice, vol 3. Mosby, Philadelphia, pp 469–514Google Scholar
  8. 8.
    Ponikau H, Sherris D, Kern E, Homburger H, Frigas E, Gaffey T, Roberts G (1999) The diagnosis and incidence of allergic fungal sinusitis. Mayo Clin Proc 74:877–884PubMedCrossRefGoogle Scholar
  9. 9.
    Stammberger H (1999) Examination and endoscopy of the nose and paranasal sinuses In: Mygind N, Lildholt T (eds) Nasal polyposis. An inflammatory disease and its treatment. Munksgaard, Copenhagen, pp 120–36Google Scholar
  10. 10.
    Manning SC, Holman M (1998) Further evidence for allergic pathophysiology in allergic fungal sinusitis. Laryngoscope 108(10):1485–1496PubMedCrossRefGoogle Scholar
  11. 11.
    Chakrabarti A, Sharma SC, Chandler J (1992) Epidemiology and pathogenesis of paranasal sinus mycoses. Otolaryngol Head Neck Surg 107(6 Pt 1):745–750PubMedGoogle Scholar
  12. 12.
    Saravanan K, Panda NK, Chakrabarti A, Das A, Bapuraj RJ (2006) Allergic fungal rhinosinusitis: an attempt to resolve the diagnostic dilemma. Arch Otolaryngol Head Neck Surg 132(2):173–178PubMedCrossRefGoogle Scholar
  13. 13.
    Chhabra A, Handa KK, Chakrabarti A, Mann SB, Panda N (1996) Allergic fungal sinusitis: clinicopathological characteristics. Mycoses 39(11–12):437–441PubMedCrossRefGoogle Scholar
  14. 14.
    Panda NK, Sharma SC, Chakrabarti A, Mann SB (1998) Paranasal sinus mycoses in north India. Mycoses 41(7–8):281–286PubMedCrossRefGoogle Scholar
  15. 15.
    Dhiwakar M, Thakar A, Bahadur S et al (2003) Preoperative diagnosis of allergic fungal sinusitis. Laryngoscope 113(4):688–694PubMedCrossRefGoogle Scholar
  16. 16.
    Taj-Aldeen SJ, Hilal AA, Schell WA (2004) Allergic fungal rhinosinusitis: a report of 8 cases. Am J Otolaryngol 25(3):213–218PubMedCrossRefGoogle Scholar
  17. 17.
    Telmesani LM (2009) Prevalence of allergic fungal sinusitis among patients with nasal polyps. Ann Saudi Med 29(3):212–214PubMedGoogle Scholar
  18. 18.
    Fereidouni M, Hossini RF, Azad FJ, Assarehzadegan MA, Varasteh A (2009) Skin prick test reactivity to common aeroallergens among allergic rhinitis patients in Iran. Allergol Immunopathol (Madr) 37(2):73–79CrossRefGoogle Scholar
  19. 19.
    Goh BS, Gendeh BS, Rose IM, Pit S, Samad SA (2005) Prevalence of allergic fungal sinusitis in refractory chronic rhinosinusitis in adult Malaysians. Otolaryngol Head Neck Surg 133(1):27–31PubMedCrossRefGoogle Scholar
  20. 20.
    Braun H, Buzina W, Freudenschuss K, Beham A, Stammberger H (2003) ‘Eosinophilic fungal rhinosinusitis’: a common disorder in Europe? Laryngoscope 113(2):264–269PubMedCrossRefGoogle Scholar
  21. 21.
    Schubert MS (2004) Allergic fungal sinusitis: pathogenesis and management strategies. Drugs 64(4):363–374PubMedCrossRefGoogle Scholar
  22. 22.
    Ryan MW, Marple BF (2007) Allergic fungal rhinosinusitis: diagnosis and management. Curr Opin Otolaryngol Head Neck Surg 15(1):18–22PubMedCrossRefGoogle Scholar
  23. 23.
    Wynn R, Har-El G (2004) Recurrence rates after endoscopic sinus surgery for massive sinus polyposis. Laryngoscope 114(5):811–813PubMedCrossRefGoogle Scholar
  24. 24.
    Lildholdt T, Rundcrantz H, Bende M, Larsen K (1997) Glucocorticoid treatment for nasal polyps. The use of topical budesonide powder, intramuscular betamethasone, and surgical treatment. Arch Otolaryngol Head Neck Surg 123(6):595–600PubMedCrossRefGoogle Scholar
  25. 25.
    Ferguson BJ (2000) Eosinophilic mucin rhinosinusitis: a distinct clinicopathological entity. Laryngoscope 110(5 Pt 1):799–813PubMedCrossRefGoogle Scholar
  26. 26.
    Ferguson BJ, Barnes L, Bernstein JM et al (2000) Geographic variation in allergic fungal rhinosinusitis. Otolaryngol Clin North Am 33(2):441–449PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Mehdi Bakhshaee
    • 1
  • Mohammad Fereidouni
    • 2
  • Morteza Nourollahian Mohajer
    • 1
  • Mohammad Reza Majidi
    • 3
  • Farahzad Jabbari Azad
    • 4
  • Toktam Moghiman
    • 5
  1. 1.Ear, Nose and Throat Research Center, Imam Reza Hospital, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
  2. 2.Asthma, Allergy and Immunology Research Center, Faculty of MedicineBirjand University of Medical SciencesBirjandIran
  3. 3.Department of Otorhinolaryngology, Ear, Nose and Throat surgery, Qaem HospitalMashhad University of Medical SciencesMashhadIran
  4. 4.Depatment of Clinical Allergy and Immunology, Allergy Research Center, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
  5. 5.Allergy Research Center. Qaem Hospital, School of MedicineMashhad University of Medical SciencesMashhadIran

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