Systemic corticosteroids for allergic fungal rhinosinusitis and chronic rhinosinusitis with nasal polyposis: A comparative study

2007 ◽  
Vol 136 (2) ◽  
pp. 252-257 ◽  
Author(s):  
Roee Landsberg ◽  
Yoram Segev ◽  
Ari DeRowe ◽  
Tali Landau ◽  
Avi Khafif ◽  
...  
Keyword(s):  
Comparative Study ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyposis ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
Systemic Corticosteroids

Radiographic Nuances in Allergic Fungal Rhinosinusitis

2019 ◽  
Vol 33 (3) ◽  
pp. 310-316 ◽  
Author(s):  
Nicholas R. Rowan ◽  
Tyler A. Janz ◽  
Rodney J. Schlosser ◽  
Zachary M. Soler
Keyword(s):  
Skull Base ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyposis ◽  
Residual Disease ◽  
Sinus Surgery ◽  
Concha Bullosa ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
Unilateral Disease ◽  
Allergic Mucin

Background Allergic fungal rhinosinusitis (AFRS) is characterized by higher revision endoscopic sinus surgery (ESS) rates and unique radiographic features when compared to chronic rhinosinusitis with nasal polyposis (CRSwNP) or chronic rhinosinusitis without nasal polyposis (CRSsNP). Objective We hypothesized that an increased frequency of concha bullosa in AFRS or other radiographic nuances might allow for accumulation of allergic mucin and contribute to increased ESS revision rates. Methods A retrospective cohort study was performed. Patient diagnosis (AFRS, CRSwNP, and CRSsNP), basic demographics, and prior ESS rates were collected. Results A total of 210 consecutive patients were included (AFRS = 70, CRSwNP = 70, and CRSsNP = 70). Pediatric AFRS patients had more unilateral disease (38.1% vs 4.4%; P = .007) and anterior ethmoid skull base erosion (23.8% vs 6.7%; P = .047) than adult AFRS patients. AFRS patients were more likely to be younger (24.9 ± 10.1 years vs 45.6 ± 14.4 years vs 48.7 ± 18.2 years; P < .001), African American (70% vs 14.3% vs 11.4%; P < .001), and have undergone prior ESS (54.3% vs 45.7% vs 31.4%; P = .02) than CRSwNP or CRSsNP patients. Concha bullosa were more prevalent in AFRS patients than CRSwNP or CRSsNP patients across the population (42.9%, 18.6%, and 14.3%; P < .001) and in the setting of no previous surgery (53.1%, 31.6%, and 16.7%; P < .001). Conclusion In this cohort, pediatric AFRS patients had more unilateral disease and anterior ethmoid skull base erosion. Concha bullosa prevalence was significantly higher in AFRS as compared to those with CRSwNP or CRSsNP, despite prior ESS. Surgeons should consider concha bullosa as a potential anatomical subsite to harbor recurrent or residual disease.

Sinonasal Surfactant Protein A1, A2, and D Gene Expression in Cystic Fibrosis: A Preliminary Report

2007 ◽  
Vol 137 (1) ◽  
pp. 34-38 ◽  
Author(s):  
Bradford A. Woodworth ◽  
Rachel Wood ◽  
John E. Baatz ◽  
Rodney J. Schlosser
Keyword(s):  
Gene Expression ◽  
Cystic Fibrosis ◽  
Nasal Polyposis ◽  
Quantitative Polymerase Chain Reaction ◽  
Surfactant Protein ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
Novel Treatment ◽  
Polymerase Chain

OBJECTIVE: To measure alterations in SPA1, A2, and D gene expression in various forms of inflammatory chronic rhinosinusitis (CRS). STUDY DESIGN AND SETTING: Sinus mucosal biopsies were performed in patients with allergic fungal rhinosinusitis (AFS), CRS with nasal polyposis, cystic fibrosis (CF), and controls. SP mRNA was measured with quantitative polymerase chain reaction. RESULTS: Patients with CF (n = 4) showed significantly increased SPA1 (82-fold), SPA2 (100-fold), and SPD (47-fold) mRNA ( P < 0.05) when compared with controls (n = 5). Patients with CRS with nasal polyposis (n = 5) also demonstrated elevated SPA1 (27-fold), SPA2 (13-fold), and SPD (13-fold). Patients with AFS (n = 7) had increased SPA1 (5-fold), SPA2 (9-fold), and SPD (17-fold), but were not statistically significant. CONCLUSION: SPA1, A2, and D are upregulated in various forms of CRS, but are significantly elevated in cystic fibrosis CRS. SIGNIFICANCE: Understanding the role of SPs in CRS will help develop novel treatment approaches for sinonasal pathoses.

scholarly journals Chronic Rhinosinusitis: Does Allergy Play a Role?

2019 ◽  
Vol 7 (2) ◽  
pp. 30 ◽  
Author(s):  
Sonya Marcus ◽  
John M. DelGaudio ◽  
Lauren T. Roland ◽  
Sarah K. Wise
Keyword(s):  
Chronic Rhinosinusitis ◽  
Strong Association ◽  
Central Compartment ◽  
Atopic Disease ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
The Relationship

A few chronic rhinosinusitis (CRS) variants have demonstrated a strong association with environmental allergy, including allergic fungal rhinosinusitis (AFRS) and central compartment atopic disease (CCAD). However, the overall relationship between CRS and allergy remains poorly defined. The goal of this review is to evaluate the relationship between CRS and allergy with a focus on specific CRS variants.

scholarly journals Nasal Polyposis and Fungal Schizophyllum Commune Infection: A Case Report

2011 ◽  
Vol 54 (2) ◽  
pp. 83-86 ◽  
Author(s):  
Aleksandar Perić ◽  
Danilo Vojvodić ◽  
Lidija Zolotarevski ◽  
Aneta Perić
Keyword(s):  
Rare Case ◽  
Nasal Polyps ◽  
Nasal Polyposis ◽  
Histopathological Examination ◽  
Schizophyllum Commune ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
Fungal Hyphae ◽  
Oral Itraconazole ◽  
Basidiomycete Fungus

We present a rare case of eosinophilic fungal rhinosinusitis with nasal polyps in a 32-year-old woman caused by basidiomycete fungusSchizophyllum commune. Diagnosis was done by the endoscopic nasal examination, computed tomography (CT) of the paranasal sinuses, the histopathological examination of polyps, the presence of eosinophils and fungal hyphae in nasal mucus and by the detection ofS. communeby culture. The patient was successfully treated by combination of oral itraconazole and topical corticosteroid therapy combined with surgery. The pathogenesis and diagnosis of allergic fungal rhinosinusitis are also discussed.

Distinguishing Molecular Features of Allergic Fungal Rhinosinusitis

2018 ◽  
Vol 159 (1) ◽  
pp. 185-193 ◽  
Author(s):  
Matthew A. Tyler ◽  
Caroline J. Padro Dietz ◽  
Chris B. Russell ◽  
Martin J. Citardi ◽  
Shervin Assassi ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Chronic Rhinosinusitis ◽  
Quantitative Polymerase Chain Reaction ◽  
Sinus Surgery ◽  
Type I ◽  
Chain Reaction ◽  
Molecular Features ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
Polymerase Chain

Objective Allergic fungal rhinosinusitis (AFRS) is a clinical subtype of chronic rhinosinusitis with nasal polyps (CRSwNP), characterized by eosinophilic mucin, evidence of fungal elements within the mucin, fungal-specific type I hypersensitivity, and characteristic computed tomography findings. It remains controversial whether AFRS represents a disease with a unique pathophysiology from chronic rhinosinusitis or is merely a severe form of CRSwNP. The goal of this study was to identify molecular features unique to AFRS. Study Design Cross-sectional case-control. Setting Single academic tertiary referral institution. Subjects and Methods Subjects included 86 patients undergoing endoscopic sinus surgery: CRSwNP (n = 34), AFRS (n = 37), and healthy controls (n = 15). Pathway and correlation analyses were performed with whole-genome microarray data for study patients undergoing surgery for recalcitrant chronic rhinosinusitis. Our findings were confirmed with quantitative polymerase chain reaction and immunohistochemical studies. Results AFRS was uniquely characterized by a pronounced association with adaptive T helper 2–associated immune gene expression. AFRS exhibited altered expression of proteins associated with secretory salivary peptides—namely, histatin, a peptide with known antifungal activity in the oral cavity. Furthermore, the expression of histatins correlated negatively with that of type 2 inflammatory mediators. We confirm the decreased expression of histatins in AFRS when compared with CRSwNP by quantitative polymerase chain reaction and localized its expression to a submucosal cell population. Conclusion There exist clear molecular profiles that distinguish AFRS from CRSwNP. This divergence translates into an altered ability to control fungal growth and may in part explain some of the phenotypical differences between CRSwNP and AFRS.

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