Ashok K Gupta
ABSTRACT Endoscopic sinus surgery plays an integral role in the management of CRS. There are welldocumented benefits in both symptoms and quality of life. The local complications such as synechiae formation, middle turbinate lateralization, and mucosal edema can impede postoperative healing and ultimately compromise long-term surgical outcomes are reported to be less than 5%. Hobson et al evaluated the utility of middle meatal packing in reducing the risk of scarring.
Shrinath D Kamath Patla, Pretty Rathnakar, Vadisha S Bhat, Jayaramesh
ABSTRACT Aim: (a) To study the variations in the superior attachment of uncinate process. (b) Incidence of pneumatization of uncinate process was also studied. Materials and methods: A total 200 sides of 100 CT scans of paranasal sinuses coronal section were studied for variations in the superior insertion of uncinate process using Landsberg and Friedman classification. Incidence of pneumatization of uncinate process was also studied. Results: In our study out of 200 sides, type 6 attachment was commonest (41%) followed by types 1 and 2. Pneumatization of the uncinate was seen in very small percentage of cases. Conclusion: Lateral insertion of uncinate (lamina papyracea + aggar nassi) is the commonest variant followed by the insertion into the skulbase. Pneumatization of uncinate is rare. Clinical significance: Though the inferior attachment of the uncinate is almost constant the superior attachment has several variations, the knowledge of which is very important for the endoscopic surgeon to avoid intraoperative complications. Keywords: Aggar nasi, Cribriform plate, Lamina papyracea, Middle turbinate, Pneumatization, Uncinate process. How to cite this article: Patla SDK, Rathnakar P, Bhat VS, Jayaramesh. A Radiological Study of Anatomical Variations of Uncinate Process. Clin Rhinol An Int J 2016;9(2):59-61. Source of support: Nil Conflict of interest: None
Vinit K Sharma, Rohit Sharma, Ashish Mehrotra, Zafar Iqbal, Kunal Nigam
ABSTRACT Erosion of bone with or without extension of disease into adjacent anatomic spaces is observed among some patients with fungal rhinosinusitis (FRS). Preoperative computed tomographies is very important to determine the sites of bony erosion. Patients with bony erosions are classified based on the involved subsite and the extent of erosion. Bony erosions was seen in 37.5% cases. Six patients were having bone erosions on CT scan. 40 % erosions were present in patients belonging to younger age group. Erosion of sinus boundaries were more common in male patients (60%). The ethmoid sinus complex was most commonly involved (46.6%). This was followed in frequency of involvement by the maxillary sinus (26.6%), the sphenoid sinus (20%) and the frontal sinus (6.6%). The most common site of erosion was the lamina papyracea (33.3%), followed by the medial maxillary wall(20%). Bony erosions due to FRS were mainly due to long-term mechanical compression by the fungal mass. A case of chronic rhinosinusitis with bony erosions in CT scan may indicate a fungal etiology. Keywords: Bony erosions, Fungal rhinosinusitis, Fungal rhinosinusitis. How to cite this article: Sharma VK, Sharma R, Mehrotra A, Iqbal Z, Nigam K. A Retrospective Study of Bony Erosion Patterns in Cases of Fungal Rhinosinusitis. Clin Rhinol An Int J 2016;9(2):62-64. Source of support: Nil Conflict of interest: None
Shilpam Sharma, Abhinav Srivastava, Chander Mohan Sharma
ABSTRACT Introduction: The correlation between middle ear pathology due to Eustachian tube dysfunction and nasal allergy has been a topic of debate since long. Studies of the pathogenesis of otitis media have identified interactions among infection, allergic reactions and Eustachian tube dysfunction. AIMS- The aim of this study was to evaluate the relationship between Eustachian tube dysfunction and nasal allergy and to evaluate the efficacy of oral steroids and intranasal steroidal spray on Eustachian tube dysfunction. Materials and methods: The patients were diagnosed according to the diagnostic criteria of allergic rhinitis. A total of 50 patients having moderate/severe symptoms who had not taken any treatment for allergic rhinitis in the past 6 weeks with deranged middle ear function were included in the study. Group I patients were given Prednisolone, 30 mg once daily for 10 days in tapering dose along with intranasal steroid spray for 6 weeks. Group II patients were given only intranasal steroid spray for 6 weeks. Impedance audiometry was repeated at the end of 6 weeks and results were statistically analyzed. Result: This study demonstrated the outcome of systemic steroids and intranasal steroidal spray in the treatment of middle ear dysfunction. In our study impedance audiometry was done at the start of study and showed type B tympanogram in 36% ears in group I and 21% in group II and type C tympanogram in 60% in group I and 50% in group II. Impedance audiometry was repeated at 10 days of treatment and showed reversal to type A curve in 26% of ears in group I and 14% of ears in group II. Impedance audiometry at the end of treatment demonstrated reversal to type A tympanogram in 64% of ears in group I and 48 % of ears in group II. Keywords: Allergic rhinitis, Intranasal steroidal spray, Middle ear dysfunction, Oral steroids. How to cite this article: Sharma S, Srivastava A, Sharma CM. Middle Ear Dysfunction: Connection to Allergic Rhinitis. Clin Rhinol An Int J 2016;9(2):65-67. Source of support: Nil Conflict of interest: None
Hemanth Vamanshankar, Satish C Kumar, AP Preetham, Musarrat Feshan
ABSTRACT Introduction: This study compares the nasal mucociliary clearance time of patients with chronic sinusitis (pre- and postoperatively) and smokers, with controls, attending the ear, nose, and throat outpatient department at Southern Railway Headquarters Hospital, Perambur, Chennai. Materials and methods: Saccharin granule was used to study mucociliary clearance as it is safe, easy, fast, and reliable. A total of 32 patients in each group were studied. In chronic rhinosinusitis patients, the test was done preoperatively and 4 weeks postoperatively. Results: The average mucociliary clearance time pre- and postoperatively in chronic rhinosinusitis patients was 29.54 ± 28.68 and 12.17 ± 5.84 respectively. Cigarette smokers had a longer mucociliary clearance time (27.63 ± 21.11) compared with beedi smokers (24.04 ± 24.93). Controls had the fastest mucociliary clearance rate of 9.67 ± 4.62 among the study subjects. Conclusion: Surgery for chronic rhinosinusitis improves both the overall symptoms of chronic rhinosinusitis and the protective functions of the nose and paranasal sinuses. Smokers had an impaired clearance rate compared with normals. As age advances, the mucociliary clearance rate becomes slower. Keywords: Chronic rhinosinusitis, Mucociliary clearance, Sacchain, Smokers. How to cite this article: Vamanshankar H, Kumar SC, Preetham AP, Feshan M. Mucociliary Function: Its Variations with Disease. Clin Rhinol An Int J 2016;9(2):68-73. Source of support: Nil Conflict of interest: None
Vinish K Agarwal, Mamta Goyal, Sampan S Bist
ABSTRACT Introduction: Allergic rhinitis (AR) is a global health problem that significantly alters patients’ social life and affects learning at school and work productivity. Materials and methods: A total of 150 patients suggestive of a history of AR were included in this study. The patients underwent a thorough history, clinical examination, diagnostic nasal endoscopic evaluation, and radiological imaging. Results: Out of 150 patients, 65% were male, whereas 35% were female ranging from age 14 to 70 years; 30% of both male and female were between 21 and 25 years; and 85% belonged to urban area, whereas 15% were rural inhabitants. The most significant complaints of patients were mainly paroxysmal sneezing, nasal obstruction, and watery nasal discharge. In the present study, 21% of patients had first-degree relatives with a complaint of AR; 72% of male patients and 75% of female patients had swollen turbinate; 59% of male patients and 62% of female patients had pale edematous nasal mucosa; 68% of male patients and 56% of female patients had granular pharyngitis; and 25% of male patients and 40% of female patients had complications of AR. Conclusion: Allergic rhinitis is a disease of youth that affects mostly people in the age group of 21 to 25 years, and it is paroxysmal sneezing that concerns most of the patients and brings them to hospital. About 60% of the patients have a history of contact with the AR patients. Clinical significance: Allergic rhinitis involves nearly 600 million people all over the world. Our study suggests three cardinal signs of AR, viz., swollen turbinate, pale and edematous nasal mucosa, and granular pharyngitis. This study also signifies female preponderance for complications of AR. Keywords: Allergic rhinitis, Complication, First-degree relatives, Paroxysmal sneezing, Swollen turbinate. How to cite this article: Agarwal VK, Goyal M, Bist SS. Study of Predisposing Factor, Clinical Profile, and Complications of Allergic Rhinitis. Clin Rhinol An Int J 2016;9(2):74-76. Source of support: Nil Conflict of interest: None
Santosh B Mane, Kalpana S Dasgupta
ABSTRACT Objective/hypothesis: Nasal and paranasal sinus disease can cause Eustachian tube (ET) dysfunction leading to middle ear (ME) hypoventilation. Persistent ME hypoventilation can result in ME conditions like retraction of tympanic membrane, otitis media with effusion, and chronic ME disease. Aim: Aim of this study was to evaluate the ET function in cases of sinonasal polyposis. Evaluation was done by doing tympanometry. Materials and methods: This was a hospital-based prospective study consisting of 42 patients (84 ears) of nasal polyposis, of which 27 patients had antrochoanal (AC) polyp and 15 patients had ethmoidal polypi. After thorough history and detail clinical examination, tympanometry was done in all patients 1 day prior to surgery and 4 to 6 weeks after surgery. Results: Preoperatively in 30 ears (15 patients) of ethmoidal polypi had normal tympanogram (A type) in 40% ears and abnormal tympanogram (B and C) in 60% ears. Postoperatively 80% had A tympanograms and 20% had abnormal tympanogram. There was significant improvement on removal of polypi (p = 0.004). Preoperatively 54 ears (27 patients) of AC polyp had normal tympanogram (type A) in 55.56% ears and abnormal tympanogram (B and C) in 44.44% ears. Postoperatively normal tympanogram was seen in 81.48% and abnormal tympanogram in 18.52% ears, so there was significant improvement after functional endoscopic sinus surgery (p = 0.007). Conclusion: Eustachian tube dysfunction was present preoperatively in 60 and 44.44% in ethmoidal and AC polypi respectively, while in postoperative period dysfunction was 20 and 18.52%. So function improves on removal of polyp. Keywords: Eustachian tube, Nasal polyp, Otitis media with effusion, Tympanogram, Tympanometry. How to cite this article: Mane SB, Dasgupta KS. Sinonasal Polyposis and Its Effect on Eustachian Tube Function. Clin Rhinol An Int J 2016;9(2):77-80. Source of support: Nil Conflict of interest: None
Pankaj Gupta, Suruchi Gupta, Amit Poredi, Zoramthara Zadeng
ABSTRACT Background: Hyaluronidase belongs to a family of enzymes that degrades hyaluronic acid, which is a constituent of the extracellular matrix. The property of hyaluronidase to help relieve tissue adhesions has found implications in epidural neuroplasty, failed back surgery syndrome, abdominal adhesions, and in prevention of formation of adhesions postoperatively in laparoscopic ventral hernia repair. There is no previous study supporting the role of hyaluronidase in relieving the adhesions around the orbital masses and aiding in their delivery. This article intends to discuss the utility of hyaluronidase in orbital mass excision by relieving adhesions around the mass. Aim: The purpose of this article is to describe the successful use of hyaluronidase intraoperatively for excision of orbital cavernous hemangioma. This patient had an orbital cavernous hemangioma of 8 years’ duration. Materials and methods: This report describes a patient who presented with unilateral proptosis of long-standing duration and visual diminution of 6 months’ duration. Radiological imaging showed presence of intraconal cavernous hemangioma in the right orbit. The patient underwent transconjunctival orbitotomy for orbital mass excision. Intraoperatively, 5 mL of injection hyaluronidase 300 IU/mL diluted in balanced salt solution was injected around the mass for adhesiolysis using a 25-gauge cannula. Conclusion: The intraoperative use of hyaluronidase helped in relieving the adhesions around the mass and helped in its easy delivery without undue manipulation. Clinical significance: Hyaluronidase is helpful in adhesiolysis around the orbital masses and promotes their easy delivery. This helps in early recovery and decreased postoperative tissue edema. This is first such report implicating the role of hyaluronidase in orbital mass excision. Keywords: Hyaluronidase, Orbital mass, Orbitotomy. How to cite this article: Gupta P, Gupta S, Poredi A, Zadeng Z. Role of Hyaluronidase in Orbital Mass Excision. Clin Rhinol An Int J 2016;9(2):81-83. Source of support: Nil Conflict of interest: None
ABSTRACT Sinonasal inverted papilloma is a benign neoplasm of epithelial origin, which represents 0.5 to 4% of all sinonasal tumors. Despite the histological benign nature of this type of tumor, it has a high rate of recurrence after surgical resection and significant malignant potential. Sinonasal inverted papilloma is treated as a locally aggressive tumor. The aggressive surgical approaches, such as en bloc resection via external excision or extensive mucosal stripping of the ipsilateral sinuses are replaced by less invasive intranasal endoscopic approaches. This creates a need for a very accurate preoperative assessment of the location of the tumor on computed tomography (CT) scan and identifies the location of the primary changes. Determination of the primary location of inverted papilloma is especially important for a radical resection of the tumor, because the tumor recurs mostly in the same location as the primary lesion. The aim of this study was to determine the relationship between changes in the preoperative CT scan of the paranasal sinuses and the location of papilloma by histological examination of surgical material. In this study, we evaluated the changes in the preoperative CT scans in the form of focal hyperostosis and erosion of the walls of the paranasal sinuses. Examined groups consisted of 12 people diagnosed with inverted papilloma and 15 peoples diagnosed with preinverted papilloma. Focal hyperostosis occurred in 83% of cases of inverted papilloma. Their location corresponded to 90% of the primal attachment of the tumor. Among the preinverted papillomas, focal hyperostosis occurred in less than 7% of the cases and did not correspond to the location of papilloma inverted. The analysis of remodeling and erosion of bone walls of the sinuses showed their presence in 67% of cases of inverted papilloma and 40% of cases of preinverted papilloma. However, their overlap with the location of the tumor was 50% for the inverted papilloma and 33% for the preinverted papilloma. Erosion and sinus bone destruction do not coincide closely with the primary location of the papilloma, because it is more the result of bone compression by the growing mass than bone invasion. The sites of focal hyperostosis closely coincide with the place of origin of the inverted papilloma, but the pathophysiological mechanism of this phenomenon is not fully understood. The relationship between the sites of focal hyperostosis and the location of the primary tumor can be used when planning surgery for accurate resection. Keywords: Computed tomography, Inverted papilloma, Site of attachment. How to cite this article: Salwa A. Sinonasal Inverted Papilloma: Evaluating the Effectiveness of Prediction of the Site of Attachment based on Computed Tomography Scans. Clin Rhinol An Int J 2016;9(2):84-86. Source of support: Nil Conflict of interest: None
Arvind Soni, Anchal Duggal
ABSTRACT A cerebrospinal fluid (CSF) leak is an escape of the fluid that surrounds the brain and spinal cord. Any tear or hole in the membrane that surrounds the brain and spinal cord (dura) can allow the fluid that surrounds those organs to leak. Most commonly, the leak is known to occur from the nose (CSF rhinorrhea) or through the ears (CSF otorrhea). Also, etiology is posttraumatic in majority. However, idiopathic CSF leakage from the eyes is extremely uncommon. Keywords: Cerebrospinal fluid oculorrhea, Cerebrospinal fluid rhinorrhea, Lamina papyracea. How to cite this article: Soni A, Duggal A. Idiopathic Cerebrospinal Fluid Oculorrhea: An Unusual Case Report. Clin Rhinol An Int J 2016;9(2):87-89. Source of support: Nil Conflict of interest: None
Tamoghna Jana, Moushumi Sengupta, Saumik Das, Asok K Saha, Subhasis Saha
ABSTRACT Retinoblastoma is the most common intraocular tumor during childhood. These tumors though respond to treatment are prone to develop second malignancy, recurrence and metastasis which may present as sinonasal mass. We are presenting a rare case of metastatic retinoblastoma of sinonasal region in a 3-year-old male child. The mode of presentation and management of the case is presented along with a review of the literature. Keywords: Metastatic, Retinoblastoma, Sinonasal. How to cite this article: Jana T, Sengupta M, Das S, Saha AK, Saha S. An Unusual ENT Presentation of Retinoblastoma: A Diagnostic Dilemma. Clin Rhinol An Int J 2016;9(2):90-93. Source of support: Nil Conflict of interest: None
Shruti Bansal, Arpit Sharma, JP Dabholkar
ABSTRACT Introduction: Maffucci syndrome is a congenital nonhereditary disorder in which patients develop multiple enchondromas and cutaneous, visceral, or soft tissue hemangiomas. Less than 200 cases of Maffucci syndrome have been published in the English literature. These lesions most commonly occur in the limb bones, especially in the hands and feet. Rarely, patients of Maffucci syndrome may present with mesodermal dysplasia involving head and neck region with nasal septum enchondromas reported only in two cases till now. Aim: To report a rare case of nasal enchondroma in a patient of Maffucci syndrome. Case description: A 15-year-old girl diagnosed with Maffucci syndrome 2 years back was referred to our ENT department with symptoms of left-sided nasal obstruction and epiphora. On thorough clinical examination and proper investigation, she was diagnosed to have nasal enchondroma. She successfully underwent endonasal endoscopic resection of nasal enchondroma. Conclusion: Maffucci syndrome is a rare entity characterized by multiple enchondromas and hemangiomas, especially in the extremities. A manifestation in the head and neck region is rare and cartilaginous tumors of nasal septum are even rarer; however, differential of nasal cartilaginous tumors should be borne in mind in patients with underlying mesodermal dysplastic disorders like Maffucci syndrome. Clinical significance: Patients of Maffucci syndrome with enchondromas are at high risk of undergoing malignant transformation, especially chondrosarcomas. These patients need vigilant and close follow-up. Despite their rarity, chondromas should be taken into consideration in the differential diagnosis of nasal tumors, especially those arising from the nasal septum. Keywords: Maffucci syndrome, Mesodermal dysplasia, Nasal enchondromas. How to cite this article: Bansal S, Sharma A, Dabholkar JP. Maffucci Syndrome with Nasal Enchondroma: A Rare Entity. Clin Rhinol An Int J 2016;9(2):94-97. Source of support: Nil Conflict of interest: None
Rijuneeta Gupta, Varun Nabh, Uma Nahar, Ashok K Gupta
ABSTRACT Mucormycosis is an opportunistic fulminant fungal infection usually noted in immunocompromised individuals like diabetic and AIDS patients, patients receiving systemic corticosteroid therapy, cancer chemotherapy, and organ transplant patients. The disease is very rare to affect healthy individuals. Here we report a case of a 21-year-old immunocompetent young male presented with cheek swelling and hard palate ulcer. Clinically, radiologically, and histologically, the diagnosis of maxillary mucormycosis was made. Keywords: Diabetic, Fungi, Immunocompetent, Mucormycosis, Necrosis. How to cite this article: Gupta R, Nabh V, Nahar U, Gupta AK. Mucormycosis Maxilla: Behavior of Disease in an Immunocompetent Young Male Patient. Clin Rhinol An Int J 2016;9(2):98-101. Source of support: Nil Conflict of interest: None
Saurabh Varshney, Manu Malhotra, Navjot Kaur, Priyanka Gairola
ABSTRACT We report a case of a 15-year-old girl presenting with left lacrimal abscess with chronic osteomyelitis of frontal bone, a rare sequelae, that of lacrimal adenitis. If lacrimal adenitis is left untreated, abscess formation can occur and can also lead to osteomyelitis. If lacrimal adenitis/abscess is diagnosed early in the disease process by understanding typical signs, conservative management can accomplish resolution without the complications and need for surgical exploration and the cosmetic implications of facial surgery. Keywords: Frontal bone, Lacrimal abscess, Osteomyelitis. How to cite this article: Varshney S, Malhotra M, Kaur N, Gairola P. Lacrimal Gland Abscess leading to Frontal Bone Chronic Osteomyelitis: A Rare Case Report. Clin Rhinol An Int J 2016;9(2):102-104. Source of support: Nil Conflict of interest: None
Damandeep K Mundi, Sanjeev Bhagat, Manjit Singh, Kushaldeep Gill
ABSTRACT Fibrous dysplasia (FD) is a benign skeletal disorder in which abnormally overgrowing bony lesion replaces the normal bone. It can affect one bone (monostotic form) or multiple bones (polyostotic form). The craniofacial bones are involved in about 10% of subjects with monostotic FD. Among FD of the head and neck, the maxilla and mandible are the most frequent sites to be involved. However, its occurrence in the sinonasal tract is very rare. We report a case of a large monostotic FD of the ethmoid bone in a 29-year-old woman. The lesion was removed by lateral rhinotomy approach and pathology proved to be FD. Keywords: Ethmoid bone, Fibrous dysplasia, Monostotic. How to cite this article: Mundi DK, Bhagat S, Singh M, Gill K. Fibrous Dysplasia of Ethmoid. Clin Rhinol An Int J 2016;9(2): 105-107. Source of support: Nil Conflict of interest: None
Ashok K Gupta
ABSTRACT There has been a major advancement in managing chronic sinusitis and other sinonasal diseases. In this changing scenario of indications for endoscopic sinus surgeries, detailed knowledge of sinonasal anatomy is of paramount importance. It is of utmost importance to master the relevant anatomy and its variations before one embarks upon endoscopic sinus surgery. So, we have tried to cover the anatomy and its variations for endoscopic sinus surgery in brief for the young and budding rhinologists in this supplement of the journal.
Ramesh C Deka
ABSTRACT In late 1970s, allergic fungal rhinosinusitis (AFRS) was discovered a clinically distinct, but immunologically similar entity to allergic bronchopulmonary aspergillosis. Both these diseases were considered as a result of noninvasive immunologic reaction toward fungal antigen. However, AFRS has been a subject of controversy and debate right from the beginning. In the initial period, it was considered as a precursor to invasive fungal sinusitis and, hence, surgical debridement followed by antifungal agents were advocated. Later studies, such as those by Manning et al and Feger et al, proved by immunologic and histologic methods that AFRS represents an immunologically-mediated disorder rather than an early stage of invasive fungal disease. In 1994, Bent and Kuhn put forward diagnostic criteria for AFRS which included type I hypersensitivity, nasal polyposis, characteristic computed tomographic (CT) findings, positive fungal stain or culture and allergic mucin. Later, further doubt in the role of fungus as an etiological agent for AFRS was created when, in 1999, Ponikau et al demonstrated the presence of fungus in 93% of patients with chronic rhinosinusitis and 100% of normal control groups.
ABSTRACT It is with immense pleasure and pride that I acknowledge that All India Rhinology Society is bringing forth this supplement on ‘fungal rhinosinusitis’ in which a management protocol has been proposed. As far as my knowledge permits, fungal rhinosinusitis is endemic to our country and such a protocol which deals with the workup, management and follow-up of such patients is the need of the hour. I truly believe that the Department of Otolaryngology and Head and Neck Surgery of our institute has immense experience in this field and the proposed protocol would help many surgeons all over the nation to treat these patients efficiently.
Ashok K Gupta, Sandeep Bansal, Daisy Sahini
ABSTRACT There has been a major advancement in managing chronic sinusitis and other sinonasal diseases. There has been a remarkable change in the surgical approach to inflammatory pathology of paranasal sinuses since the time, Messerklinger introduced endoscopic sinus surgery. In this changing scenario of indications for endoscopic sinus surgeries, detailed knowledge of sinonasal anatomy is of paramount importance. It is of utmost importance to master the relevant anatomy and its variations before one embarks upon endoscopic sinus surgery. Various cadaveric and radiological studies have been done to know about the important landmarks and anatomical variations. With increasing horizon of sinus surgery, where more of optic nerve and anterior and middle cranial fossa lesions are being dealt with endoscopically; surgeon needs to be more familiar with various variations in the anatomy of the important structures as even a small mistake can be detrimental to the vision and life of the patient. Keywords:Anatomy, Endoscopic sinus surgery, Cadaveric dissection, Anatomical variations. How to cite this article: Gupta AK, Bansal S, Sahini D. Anatomy and Its Variations for Endoscopic Sinus Surgery. Clin Rhinol An Int J 2012;5(2):55-62. Source of support: Nil Conflict of interest: None declared
Ashok K Gupta, Sandeep Bansal, Rijuneeta, Bhumika Gupta
ABSTRACT Invasive sinus Aspergillus infection has been reported in the last decade with increased frequency, most commonly in the setting of hematologic malignancy, neutropenia, HIV infection and other states of immunosuppression. Fungal rhinosinusitis can be broadly classified into two varieties—invasive and noninvasive on the basis of tissue invasion. Invasive fungal sinusitis are acute invasive, chronic invasive (both granulomatous and nongranulomatous forms), whereas noninvasive are fungus balls and allergic fungal sinusitis. Invasive fungal sinusitis is one of the most challenging forms of sinonasal pathology to manage, most commonly presenting in immunocompromised individuals. Chronic invasive being sinus aspergillosis (CISA) is being reported in immunocompetent patients at an increasing rate while most of these cases are being reported from the India subcontinent and middle east. Invasive fungal sinusitis is on the rise worldwide and especially in north India as it is endemic in this part of the country. It is affecting immunocompetent young and middle aged population causing a great morbidity and mortality. This entity needs to be picked up early by spreading awareness among the family physicians, internists, otolaryngologists, ophthalmologists, neurosurgeons, pulmonary physicians, critical care specialists so that an early management can initiated to achieve better control over the disease. This review is an attempt to initiate an interdisciplinary approach to achieve a better outcome. Keywords: Rhinosinusitis, Fungal sinusitis, Invasive, Nose and paranasal sinuses. How to cite this article: Gupta AK, Bansal S, Rijuneeta, Gupta B. Invasive Fungal Sinusitis. Clin Rhinol An Int J 2012;5(2): 63-71. Source of support: Nil Conflict of interest: None declared
Ashok K Gupta, Nishit Shah, Mohan Kameswaran, Davinder Rai, TN Janakiram, Hemant Chopra, Ravi Nayar, Arvind Soni, NK Mohindroo, C Madhu Sudana Rao, Sandeep Bansal, KR Meghnadh, Neelam Vaid, Hetal Marfatia Patel, Sanjay Sood, Sunita Kanojia, Kshitij Charaya, SC Pandhi, SBS Mann
ABSTRACT Allergic fungal rhinosinusitis (AFRS) has always remained a topic of discussion at all rhinology meets. Despite so much of literature available, the nature of this disease, its diagnosis, pathogenesis, classification and appropriate management continue to generate debate and controversy even after three decades of research and investigation. AFRS is an endemic disease in North and South India. In spite of this, there has been no optimal management protocol for this disease being followed in India yet. To overcome this, a national panel was conducted on AFRS at the ENT Surgical Update 2011, held at Postgraduate Institute of Medical Education and Research, Chandigarh with experts from all over the country so that a consensus can be achieved regarding the workup and management of AFRS. Keywords: Rhinosinusitis, Allergic fungal sinusitis, Management protocol. How to cite this article: Gupta AK, Shah N, Kameswaran M, Rai D, Janakiram TN, Chopra H, Nayar R, Soni A, Mohindroo NK, Rao CMS, Bansal S, Meghnadh KR, Vaid N, Patel HM, Sood S, Kanojia S, Charaya K, Pandhi SC, Mann SBS. Allergic Fungal Rhinosinusitis. Clin Rhinol An Int J 2012;5(2): 72-86. Source of support: Nil Conflict of interest: None declared
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