Contralateral sinus involvement of surgically treated unilateral allergic fungal rhinosinusitis
Recurrence of allergic fungal rhinosinusitis (AFRS) is well recognized. However, there is scarcity in the literature describing involvement of the non-diseased sinuses. We aimed to evaluate the recurrence forms of unilateral AFRS as well as to study the possible predictor factors of developing the d...
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Published in | European archives of oto-rhino-laryngology Vol. 274; no. 8; pp. 3097 - 3101 |
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Main Authors | , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
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Berlin/Heidelberg
Springer Berlin Heidelberg
01.08.2017
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Abstract | Recurrence of allergic fungal rhinosinusitis (AFRS) is well recognized. However, there is scarcity in the literature describing involvement of the non-diseased sinuses. We aimed to evaluate the recurrence forms of unilateral AFRS as well as to study the possible predictor factors of developing the disease in the contralateral side. Patients with exclusive unilateral AFRS from (2010 to 2015) were enrolled in multi-institutional case–control study. All patients were evaluated after endoscopic sinus surgery for recurrence. Patient’s records were reviewed for demographics, medical treatment, and clinical, radiological, and surgical data. A total of 68 patients were identified. Delayed contralateral involvement after the initial surgery was found in 30.8% with mean duration of recurrence 16.9 months. A significant association was found with the presence of pre-operative contralateral symptoms and signs of inflammation (OR 3.49, 95% CI 1.19–10.22,
p
value 0.02). Post-operative use of budesonide irrigation was associated with less contralateral involvement (OR 0.11, 95% CI 0.01–0.87,
p
value 0.01). Association of other variables like: comorbidities, perioperative use of systemic steroid, radiological signs, extent of surgery, additional surgery to the contralateral side, and post-operative use of systemic steroids did not show statistical significance. Involvement of the contralateral sinuses in 30% of unilateral AFRS cases is considered significant. The non-diseased sinuses should be involved in the routine endoscopic examination and post-operative treatment. Further studies are necessary to investigate the possibility of prophylactic surgical intervention of the non-diseased sinuses. |
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AbstractList | Recurrence of allergic fungal rhinosinusitis (AFRS) is well recognized. However, there is scarcity in the literature describing involvement of the non-diseased sinuses. We aimed to evaluate the recurrence forms of unilateral AFRS as well as to study the possible predictor factors of developing the disease in the contralateral side. Patients with exclusive unilateral AFRS from (2010 to 2015) were enrolled in multi-institutional case-control study. All patients were evaluated after endoscopic sinus surgery for recurrence. Patient's records were reviewed for demographics, medical treatment, and clinical, radiological, and surgical data. A total of 68 patients were identified. Delayed contralateral involvement after the initial surgery was found in 30.8% with mean duration of recurrence 16.9 months. A significant association was found with the presence of pre-operative contralateral symptoms and signs of inflammation (OR 3.49, 95% CI 1.19-10.22, p value 0.02). Post-operative use of budesonide irrigation was associated with less contralateral involvement (OR 0.11, 95% CI 0.01-0.87, p value 0.01). Association of other variables like: comorbidities, perioperative use of systemic steroid, radiological signs, extent of surgery, additional surgery to the contralateral side, and post-operative use of systemic steroids did not show statistical significance. Involvement of the contralateral sinuses in 30% of unilateral AFRS cases is considered significant. The non-diseased sinuses should be involved in the routine endoscopic examination and post-operative treatment. Further studies are necessary to investigate the possibility of prophylactic surgical intervention of the non-diseased sinuses. Recurrence of allergic fungal rhinosinusitis (AFRS) is well recognized. However, there is scarcity in the literature describing involvement of the non-diseased sinuses. We aimed to evaluate the recurrence forms of unilateral AFRS as well as to study the possible predictor factors of developing the disease in the contralateral side. Patients with exclusive unilateral AFRS from (2010 to 2015) were enrolled in multi-institutional case–control study. All patients were evaluated after endoscopic sinus surgery for recurrence. Patient’s records were reviewed for demographics, medical treatment, and clinical, radiological, and surgical data. A total of 68 patients were identified. Delayed contralateral involvement after the initial surgery was found in 30.8% with mean duration of recurrence 16.9 months. A significant association was found with the presence of pre-operative contralateral symptoms and signs of inflammation (OR 3.49, 95% CI 1.19–10.22, p value 0.02). Post-operative use of budesonide irrigation was associated with less contralateral involvement (OR 0.11, 95% CI 0.01–0.87, p value 0.01). Association of other variables like: comorbidities, perioperative use of systemic steroid, radiological signs, extent of surgery, additional surgery to the contralateral side, and post-operative use of systemic steroids did not show statistical significance. Involvement of the contralateral sinuses in 30% of unilateral AFRS cases is considered significant. The non-diseased sinuses should be involved in the routine endoscopic examination and post-operative treatment. Further studies are necessary to investigate the possibility of prophylactic surgical intervention of the non-diseased sinuses. |
Author | Aloulah, M. Alsaleh, S. Musleh, A. Mokarbesh, H. Marglani, O. Alamri, A. Alfawwaz, F. Alqahtani, A. Alshammari, F. Alandejani, T. Alzarei, A. AlQahtani, Abdulaziz Alshaikh, N. |
Author_xml | – sequence: 1 givenname: Abdulaziz surname: AlQahtani fullname: AlQahtani, Abdulaziz email: Qahtani24@hotmail.com organization: Department of Otolaryngology Head and Neck Surgery, Prince Sultan Military Medical City – sequence: 2 givenname: N. surname: Alshaikh fullname: Alshaikh, N. organization: Department of Otolaryngology Head and Neck Surgery, Dammam Medical Complex – sequence: 3 givenname: A. surname: Alzarei fullname: Alzarei, A. organization: Department of Otolaryngology Head and Neck Surgery, King Khalid University – sequence: 4 givenname: A. surname: Musleh fullname: Musleh, A. organization: Department of Otolaryngology Head and Neck Surgery, King Khalid University – sequence: 5 givenname: A. surname: Alamri fullname: Alamri, A. organization: Department of Otolaryngology Head and Neck Surgery, King Salman Hospital – sequence: 6 givenname: A. surname: Alqahtani fullname: Alqahtani, A. organization: Department of Otolaryngology Head and Neck Surgery, Khamis Mushait General Hospital – sequence: 7 givenname: F. surname: Alfawwaz fullname: Alfawwaz, F. organization: Department of Otolaryngology Head and Neck Surgery, King Fahad Medical City – sequence: 8 givenname: F. surname: Alshammari fullname: Alshammari, F. organization: Department of Otolaryngology Head and Neck Surgery, King Khalid Hospital – sequence: 9 givenname: M. surname: Aloulah fullname: Aloulah, M. organization: Department of Otolaryngology Head and Neck Surgery, King Saud University Medical City, King Abdulaziz Hospital – sequence: 10 givenname: O. surname: Marglani fullname: Marglani, O. organization: Department of Otolaryngology Head and Neck Surgery, Umm Al-Qura University – sequence: 11 givenname: S. surname: Alsaleh fullname: Alsaleh, S. organization: Department of Otolaryngology Head and Neck Surgery, King Saud University Medical City, King Abdulaziz Hospital – sequence: 12 givenname: T. surname: Alandejani fullname: Alandejani, T. organization: Department of Otolaryngology Head and Neck Surgery, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City – sequence: 13 givenname: H. surname: Mokarbesh fullname: Mokarbesh, H. organization: Department of Otolaryngology Head and Neck Surgery, Prince Mohammed bin Naser Hospital |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/28501959$$D View this record in MEDLINE/PubMed |
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Cites_doi | 10.1177/019459989411100508 10.1002/lary.20520 10.21053/ceo.2016.00220 10.1097/MOO.0b013e328013dbd9 10.1002/alr.21292 10.1002/alr.21189 10.1002/alr.21352 10.1177/0194599815580978 10.1016/j.bjorl.2015.03.014 10.1016/j.otohns.2004.04.004 10.1016/j.otohns.2007.10.020 10.2500/ajra.2010.24.3533 10.1016/S0030-6665(03)00152-X 10.2500/ajra.2013.27.3891 10.1016/j.otohns.2005.11.013 10.1016/j.otohns.2005.03.028 10.1097/00005537-200106000-00015 10.5144/0256-4947.2009.212 |
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Keywords | Allergic fungal rhinosinusitis Recurrence Budesonide Contralateral FESS |
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Snippet | Recurrence of allergic fungal rhinosinusitis (AFRS) is well recognized. However, there is scarcity in the literature describing involvement of the non-diseased... |
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SubjectTerms | Adult Budesonide - therapeutic use Case-Control Studies Female Glucocorticoids - therapeutic use Head and Neck Surgery Humans Male Medicine Medicine & Public Health Mycoses - therapy Neurosurgery Otorhinolaryngology Paranasal Sinuses - diagnostic imaging Paranasal Sinuses - microbiology Recurrence Retrospective Studies Rhinitis, Allergic, Perennial - microbiology Rhinitis, Allergic, Perennial - surgery Rhinology Sinusitis - microbiology Sinusitis - surgery Therapeutic Irrigation |
Title | Contralateral sinus involvement of surgically treated unilateral allergic fungal rhinosinusitis |
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