Abstract
AMAÇ
Fungal sinüzit daha önceleri nadir görülen bir hastalık olarak kabul edilen, ancak son zamanlarda sıcak iklimlerde artan sıklıkta bildirilen bir hastalıktır. Fungal sinüzit sınıflandırması son yirmi yılda gelişmiştir ve beş alt tip içerdiği söylenmektedir. Farklı tiplerinin anlaşılması ve bunların radyolojik özelliklerinin bilinmesi doğru ve hızlı tanı ile uygun tedavinin başlatılması açısından önemlidir. Çalışmamızda Alerjik Fungal Sinüzit (AFS) tanısına yardımcı olabilecek yeni bir bulgu olan serrated konka varlığı ile ılıman iklim kuşağında yer alan ülkemizde AFS’nin radyolojik bulgularının literatürde belirtilenler ile farklılığının bulunup bulunmadığını araştırmayı amaçladık.
GEREÇ VE YÖNTEM
Çalışmamıza Ocak 2019 – Eylül 2021 tarihleri arasında merkezimizde paranazal sinüs BT incelemesi yapılan 120 hasta dahil edilmiştir. Hastalardan alerjik testler ve/veya fungal kültür incelemeleri sonucu AFS tanısı konulanlar birinci grup, AFS dışı rinosinüzit tanısı konulan hastalar ikinci gruba dahil edilmiştir. Görüntülerde serrated konka görünümünün varlığı, polip varlığı, bone erosion varlığı ve CT hiperdansitesi varlığı araştırılmıştır.
BULGULAR
Çalışmamızda AFS’nin radyolojik özellikleri diğer rinosinüzitlerle karşılaştırılmış olup serrated turbinate görünümünün AFS için istatistiksel farklılığını tespit ettik (p<0.05). Kemik erozyon, polip mevcudiyeti ve CT hiperdansitesi ise farklılık göstermemekteydi (p>0.05).
SONUÇ
Ortaya koyduğumuz bulgular AFS tanısı için serrated konka görünümünün ayırıcı tanıda faydalı bir belirteç olabileceğini göstermiştir. Kemik erozyonun kemik yapıdaki diğer şekil ve yapı değişikliklerinden ayrı değerlendirilmesi, sinüs opasifikasyonu için de dansite değerinin belirtilmesi gerekmektedir.
Supporting Institution
YOK
Project Number
YOK
Thanks
YOK
References
- Safirstein BH. Allergic bronchopulmonary aspergillosis with obstruction of the upper respiratory tract. Chest 1976;70:788e90.
- Millar JW, Johnston A, Lamb D. Allergic aspergillosis of the maxillary sinuses. Thorax 1981;36:710.
- Katzenstein AL, Sale SR, Greenberger PA. Allergic Aspergillus sinusitis: a newly recognized form of sinusitis. J Allergy Clin Immunol 1983;72:89-93.
- Robson JM, Hogan PG, Benn RA, et al. Allergic fungal sinusitis presenting as a paranasal sinus tumour. Aust N Z J Med 1989;19:351-3.
- Soler ZM, Schlosser RJ. The role of fungi in diseases of the nose and sinuses. Am J Rhinol Allergy 2012;26:351-8
- Önerci M, Ünal ÖF, Öğretmenoğlu O. K.B.B. ve Baş Boyun Cerrahisi Dergisi 1994; 2: 87-88
- Aribandi M, McCoy V, Bazan C. Imaging features of invasive and noninvasive fungal sinusitis: a review. Radiographics 2007;27:1283–96
- Scadding, GK, Durham, SR, Mirakian, R. BSACI guidelines for the management of rhinosinusitis and nasal polyposis. Clin Exp Allergy. 2007;38:260-275.
- Pravilika P., Rajasekar M. K. A Cross Sectional Study on Prevalence and Management of Fungal Sinusitis. Annals of the Romanian Society for Cell Biology, 2021, 4000–4014
- Bent JP, Kuhn FA Diagnosis of allergic fungal sinusitis. Otolaryngol Head Neck Surg 1994;99:475–485
- Mukherji SK, Figueroa RE, Ginsberg LE, et al. Allergic fungal sinusitis: CT findings. Radiology 1998;207:417e22.
- Zinreich SJ, Kennedy DW, Malat J, et al. Fungal sinusitis: diagnosis with CT and MR imaging. Radiology 1988;169:439-44.
- Manning SC, Merkel M, Kreisel K, Vuitch F, Marple B. Computed tomographic and magnetic resonance diagnosis of allergic fungal sinusitis. Laryngoscope 1997;107: 170–176.
- Pillai S, Bhandarkar AM, Nair SS, Jha AT, Ramaswamy B, Al-Abri R. A radiological profile of fungal sinusitis. Asian J Pharm Clin Res 2017;10:331-4.
- Marple, B.F. Allergic Fungal Rhinosinusitis: Current Theories and Management Strategies. The Laryngoscope, 2001;111:1006-1019.
- Meng Y, Zhang L, Piao Y, Lou H, Wang K, Wang C. The use of magnetic resonance imaging in differential diagnosis of allergic fungal sinusitis and eosinophilic mucin rhinosinusitis. Journal of thoracic disease. 2019 Aug;11(8):3569.
- Khattar V.S.,Hathiram B.T. Radiologic appearances of fungal sinusitis. Otorhinolaryngol Clin Int J. 2009; 1: 15-23
- Dhiwakar, M., Thakar, A., Bahadur, S. et al. Preoperative Diagnosis of Allergic Fungal Sinusitis. The Laryngoscope, 2003;113: 688-694.
- Gavito-Higuera J, Mullins CB, Ramos-Duran L, Sandoval H, Akle N, Figueroa R. Sinonasal Fungal Infections and Complications: A Pictorial Review. J Clin Imaging Sci 2016;6:23.
- Nussenbaum B, Marple BF, Schwade ND. Characteristics of bone erosion in allergic fungal sinusitis. Otolaryngol Head Neck Surg 2001;124:150-54.
- Al-Dousary S. H., “Allergic fungal sinusitis: radiological and microbiological feature of 59 cases,” Annals of Saudi Medicine, vol. 28, no. 1, pp. 17–21, 2008.
- Ni Mhurchu E, Ospina J, Janjua AS, Shewchuk JR, Vertinsky AT. Fungal Rhinosinusitis: A Radiological Review with Intraoperative Correlation. Canadian Association of Radiologists Journal. 2017;68(2):178-186.
- Zain-Alabdeen EH, , El Khateeb SM. Incidental cone beam computed tomographic findings among Taibah university patients, KSA: a retrospective study. J Taibah Univ Med Sci 2017; 12: 131–8.
Abstract
AIM
Fungal sinusitis is a disease that was previously considered a rare disease, but has recently been reported with increasing frequency in warm climates. Fungal sinusitis classification has evolved over the past two decades and is said to include five subtypes. Discrimination of different subtypes and knowing their radiological features are important for accurate and rapid diagnosis and initiation of appropriate treatment. In our study, we aimed to investigate whether there is a difference between the radiological findings of AFS with a newly defined finding that may help the diagnosis of AFS; serrated turbinate and those reported in the literature.
MATERIALS AND METHODS
Our study included 120 patients who underwent paranasal sinus computed tomography examination in our center between January 2019 and September 2021. Patients diagnosed with AFS as a result of allergic tests and/or fungal culture examinations were included in the first group, and patients diagnosed with non-AFS rhinosinusitis were included in the second group. Presence of serrated turbinate appearence, polyps, bone erosion, CT hyperdensity were evaluated in the images.
RESULTS
The radiological features of AFS and non-AFS were compaired and serrated turbinate appearence was found to be statistically signifant in AFS (p<0.05). Bone erosion, presence of polyps and CT hyperdensity did not differ between the groups (p>0.05).
CONCLUSION
Our findings showed that serrated turbinate appearence may be a useful radiological marker in the diagnosis of AFS. Bone erosion should be evaluated seperately from other morphological and structural changes in the bone structure, and the bone density measurements should be specified for sinus opacification.
Project Number
YOK
References
- Safirstein BH. Allergic bronchopulmonary aspergillosis with obstruction of the upper respiratory tract. Chest 1976;70:788e90.
- Millar JW, Johnston A, Lamb D. Allergic aspergillosis of the maxillary sinuses. Thorax 1981;36:710.
- Katzenstein AL, Sale SR, Greenberger PA. Allergic Aspergillus sinusitis: a newly recognized form of sinusitis. J Allergy Clin Immunol 1983;72:89-93.
- Robson JM, Hogan PG, Benn RA, et al. Allergic fungal sinusitis presenting as a paranasal sinus tumour. Aust N Z J Med 1989;19:351-3.
- Soler ZM, Schlosser RJ. The role of fungi in diseases of the nose and sinuses. Am J Rhinol Allergy 2012;26:351-8
- Önerci M, Ünal ÖF, Öğretmenoğlu O. K.B.B. ve Baş Boyun Cerrahisi Dergisi 1994; 2: 87-88
- Aribandi M, McCoy V, Bazan C. Imaging features of invasive and noninvasive fungal sinusitis: a review. Radiographics 2007;27:1283–96
- Scadding, GK, Durham, SR, Mirakian, R. BSACI guidelines for the management of rhinosinusitis and nasal polyposis. Clin Exp Allergy. 2007;38:260-275.
- Pravilika P., Rajasekar M. K. A Cross Sectional Study on Prevalence and Management of Fungal Sinusitis. Annals of the Romanian Society for Cell Biology, 2021, 4000–4014
- Bent JP, Kuhn FA Diagnosis of allergic fungal sinusitis. Otolaryngol Head Neck Surg 1994;99:475–485
- Mukherji SK, Figueroa RE, Ginsberg LE, et al. Allergic fungal sinusitis: CT findings. Radiology 1998;207:417e22.
- Zinreich SJ, Kennedy DW, Malat J, et al. Fungal sinusitis: diagnosis with CT and MR imaging. Radiology 1988;169:439-44.
- Manning SC, Merkel M, Kreisel K, Vuitch F, Marple B. Computed tomographic and magnetic resonance diagnosis of allergic fungal sinusitis. Laryngoscope 1997;107: 170–176.
- Pillai S, Bhandarkar AM, Nair SS, Jha AT, Ramaswamy B, Al-Abri R. A radiological profile of fungal sinusitis. Asian J Pharm Clin Res 2017;10:331-4.
- Marple, B.F. Allergic Fungal Rhinosinusitis: Current Theories and Management Strategies. The Laryngoscope, 2001;111:1006-1019.
- Meng Y, Zhang L, Piao Y, Lou H, Wang K, Wang C. The use of magnetic resonance imaging in differential diagnosis of allergic fungal sinusitis and eosinophilic mucin rhinosinusitis. Journal of thoracic disease. 2019 Aug;11(8):3569.
- Khattar V.S.,Hathiram B.T. Radiologic appearances of fungal sinusitis. Otorhinolaryngol Clin Int J. 2009; 1: 15-23
- Dhiwakar, M., Thakar, A., Bahadur, S. et al. Preoperative Diagnosis of Allergic Fungal Sinusitis. The Laryngoscope, 2003;113: 688-694.
- Gavito-Higuera J, Mullins CB, Ramos-Duran L, Sandoval H, Akle N, Figueroa R. Sinonasal Fungal Infections and Complications: A Pictorial Review. J Clin Imaging Sci 2016;6:23.
- Nussenbaum B, Marple BF, Schwade ND. Characteristics of bone erosion in allergic fungal sinusitis. Otolaryngol Head Neck Surg 2001;124:150-54.
- Al-Dousary S. H., “Allergic fungal sinusitis: radiological and microbiological feature of 59 cases,” Annals of Saudi Medicine, vol. 28, no. 1, pp. 17–21, 2008.
- Ni Mhurchu E, Ospina J, Janjua AS, Shewchuk JR, Vertinsky AT. Fungal Rhinosinusitis: A Radiological Review with Intraoperative Correlation. Canadian Association of Radiologists Journal. 2017;68(2):178-186.
- Zain-Alabdeen EH, , El Khateeb SM. Incidental cone beam computed tomographic findings among Taibah university patients, KSA: a retrospective study. J Taibah Univ Med Sci 2017; 12: 131–8.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original Research |
| Authors | |
| Project Number | YOK |
| Publication Date | November 20, 2021 |
| Acceptance Date | November 18, 2021 |
| Published in Issue | Year 2021 Volume: 11 Issue: 6 |
