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Benali O, Bankole NDA, Melhaoui A, Boutarbouch M, El Ouahabi A. Paranasal sinus Osteoma with Mucocele: A case report and literature review. INTERDISCIPLINARY NEUROSURGERY 2023. [DOI: 10.1016/j.inat.2023.101759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
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AlAhmari AA. Allergic Fungal Rhinosinusitis in Saudi Arabia: A Review of Recent Literature. Cureus 2021; 13:e20683. [PMID: 35106223 PMCID: PMC8785804 DOI: 10.7759/cureus.20683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2021] [Indexed: 11/12/2022] Open
Abstract
Allergic fungal rhinosinusitis (AFRS) has been considered an enigma since it was first described four decades ago. Previous research has found that AFRS has multiple definitions and a poorly understood pathogenesis because it overlaps with other conditions and necessitates meticulous work and multiple diagnostic modalities to confirm the diagnosis. However, despite the expansion of medical and surgical treatments, recurrence still occurs. In this review, the recent literature on AFRS cases in Saudi Arabia with relevance to its epidemiology, diagnosis, and management was studied and compared with international data. PubMed, Google Scholar, and Cochrane Library were searched for original research and review articles with local data. There is an evident paucity and contradiction between local studies regarding the epidemiology, diagnostic methods, and management of AFRS. Hence, well-defined randomized controlled trials (RCTs) are needed for the treatment of this chronic recurrent disease.
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3
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Isolated sphenoid allergic fungal sinusitis causing bilateral blindness. OTOLARYNGOLOGY CASE REPORTS 2020. [DOI: 10.1016/j.xocr.2020.100153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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4
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Roncone DP. Frontoethmoidal mucocele presenting with ocular manifestations. Clin Exp Optom 2019; 103:610-617. [PMID: 31773805 DOI: 10.1111/cxo.13006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/19/2019] [Accepted: 10/09/2019] [Indexed: 11/30/2022] Open
Abstract
Mucocele of the paranasal sinuses is a slowly expanding benign lesion developing when there is impeded physiological drainage of the mucous produced by the epithelial lining of the paranasal sinuses, at the sinus ostium, which is an opening that connects the sinus to the nasal cavity. Aetiologies of ostial occlusion include infection, allergy, trauma, previous surgery, benign neoplasm (osteoma or fibrous dysplasia), and malignant or metastatic tumours. Mucoceles commonly develop in the frontal sinus (70-80 per cent), followed by the ethmoid (25 per cent), frontoethmoidal (10-14 per cent), and maxillary (three per cent or less) sinuses. The most common manifestations in these cases are ocular oedema, proptosis (22-83 per cent), and diplopia (28 per cent). Due to these ocular signs and symptoms, the optometrist may be first in line managing paranasal sinus disease patients, reducing the risk of permanent damage. A case report and review of frontoethmoidal mucocele will be discussed in this report, to include the role of the optometrist in its management and treatment.
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Affiliation(s)
- David P Roncone
- Optometry Clinic, Cleveland Veterans Affairs Medical Center, Cleveland, Ohio, USA
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Sekhar V, Ao J, Iqbal I, Ooi EH, Munn Z. Effectiveness of endoscopic versus external surgical approaches in the treatment of orbital complications of rhinosinusitis: a systematic review protocol. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2019; 17:2378-2389. [PMID: 31313706 DOI: 10.11124/jbisrir-2017-003972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
OBJECTIVE This review aims to investigate and compare the effectiveness of endoscopic drainage techniques against external drainage techniques for the treatment of orbital and subperiosteal abscesses as a complication of rhinosinusitis. INTRODUCTION Transnasal endoscopic drainage and external drainage techniques have been used in the management of subperiosteal orbital abscesses secondary to rhinosinusitis. Each of these approaches has its own advantages and disadvantages, with extensive literature describing each technique separately. However, there is a lack of guidance in the studies on assessing and comparing the safety, effectiveness and suitability of these techniques. This review aims to compare the effectiveness of these techniques based on measuring outcomes in the literature such as: length of postoperative hospital stay, rate of revision surgery and complication rates. INCLUSION CRITERIA Eligible studies will include people of all ages diagnosed with subperiosteal abscess, orbital abscess or cavernous sinus thrombosis (Chandler stages III-V) secondary to rhinosinusitis disease, who have also undergone drainage via either an endoscopic approach, external approach or combined surgical approach. METHODS A comprehensive search of both published and unpublished literature will be performed to uncover studies meeting the inclusion criteria. Reference lists of studies included in final analyses will also be manually searched and subject matter experts contacted to investigate other sources of literature. Two reviewers will screen studies and a third reviewer will resolve disagreements. Studies will, where possible, be pooled in statistical meta-analysis with heterogeneity of data being assessed using the standard Chi-squared and I tests.
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Affiliation(s)
- Vimal Sekhar
- Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Department of Otolaryngology Head and Neck Surgery, Flinders Medical Centre, Adelaide, Australia
| | - Jack Ao
- South Australian Institute of Ophthalmology, Discipline of Ophthalmology and Visual Sciences, The University of Adelaide, Adelaide, Australia
| | - Isma Iqbal
- Department of Otolaryngology Head and Neck Surgery, Flinders Medical Centre, Adelaide, Australia
| | - Eng Hooi Ooi
- Department of Otolaryngology Head and Neck Surgery, Flinders Medical Centre, Adelaide, Australia
| | - Zachary Munn
- Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
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Zukin LM, Hink EM, Liao S, Getz AE, Kingdom TT, Ramakrishnan VR. Endoscopic Management of Paranasal Sinus Mucoceles: Meta-analysis of Visual Outcomes. Otolaryngol Head Neck Surg 2017; 157:760-766. [PMID: 28695766 DOI: 10.1177/0194599817717674] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective Paranasal sinus mucoceles are benign cystic lesions originating from sinus mucosa that can impinge on adjacent orbital structures, causing ophthalmic sequelae such as decreased visual acuity. Definitive treatment requires surgery. We present the first meta-analysis quantifying the effect of preoperative visual function and time to surgery on postoperative visual acuity outcomes. Data Sources PubMed, Ovid, Embase, Web of Science, and the Cochrane Library. Methods Two independent authors systematically reviewed articles describing outcomes after endoscopic sinus surgery for paranasal sinus mucoceles presenting with visual loss. Available data from case reports and series were combined to analyze the associations among preoperative visual acuity, time to surgery, and postoperative outcomes. Results Eighty-five studies were included that provided data on 207 patients. The average presenting visual acuity was 1.57 logMAR (logarithm of the minimum angle of resolution), and the average postoperative visual acuity was 0.21 logMAR, with visual improvement in 71.5% of cases. Preoperative visual acuity ≥1.52 logMAR correlated with postoperative improvement >1 logMAR ( R = 0.4887, P < .0001). A correlation was found between a time to surgery <6 days and postoperative improvement ( R = 0.297, P < .0001). Receiver operator curve analysis of these thresholds demonstrated a moderately accurate prognostic ability (area under the curve: 75.1 for preoperative visual acuity and 73.1 for time to surgery). Conclusion Visual loss resulting from paranasal sinus mucoceles is potentially reversible in most cases, even those presenting with poor vision. When possible, surgery should be performed promptly after diagnosis, but emergency surgery does not appear to be necessary for vision restoration.
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Affiliation(s)
- Leonid M Zukin
- 1 University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Eric M Hink
- 2 Division of Oculoplastic Surgery, Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Sophie Liao
- 2 Division of Oculoplastic Surgery, Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Anne E Getz
- 3 Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Todd T Kingdom
- 2 Division of Oculoplastic Surgery, Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, USA.,3 Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Vijay R Ramakrishnan
- 3 Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado, USA.,4 Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado, USA
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Tong J, Jefferson N, Chaganti J, Fraser CL. Compressive Optic Neuropathy from Allergic Fungal Sinusitis. Neuroophthalmology 2015; 39:236-239. [PMID: 27928361 DOI: 10.3109/01658107.2015.1056380] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 05/25/2015] [Accepted: 05/26/2015] [Indexed: 11/13/2022] Open
Abstract
Ophthalmic manifestations of allergic fungal sinusitis (AFS) are rare, but can occur in advanced disease. A 32-year-old man with advanced AFS presented with severe bilateral vision loss and restricted ocular motility. Magnetic resonance imaging and histological analysis confirmed active chronic AFS. Functional endoscopic sinus surgery was performed, with adjunctive steroid therapy. Although AFS is a reasonably well-recognised entity, severe disease causing bilateral visual deficits is rarely encountered. This can confound the diagnosis and appropriate treatment. Ophthalmologists should thus be aware of compressive optic neuropathy as a complication of advanced AFS to prompt early treatment and mitigate visual loss.
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Affiliation(s)
- Jessica Tong
- Department of Ophthalmology, St. Vincent's Hospital , Sydney, Darlinghurst, New South Wales, Australia
| | - Niall Jefferson
- Department of Ear, Nose and Throat, St. Vincent's Hospital , Sydney, Darlinghurst, New South Wales, Australia
| | - Joga Chaganti
- Department of Neuroradiology, St. Vincent's Hospital , Sydney, Darlinghurst, New South Wales, Australia , and
| | - Clare L Fraser
- Save Sight Institute , Sydney, New South Wales, Australia
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Evans MO, Coop CA. Novel treatment of allergic fungal sinusitis using omalizumab. ALLERGY & RHINOLOGY 2015; 5:172-4. [PMID: 25565055 PMCID: PMC4275465 DOI: 10.2500/ar.2014.5.0098] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A case report of recalcitrant allergic fungal sinusitis (AFS) refractory to systemic corticosteroids and multiple functional endoscopic sinus surgeries (FESSs) treated with anti-IgE antibody omalizumab is reported. AFS is often classified with chronic rhinosinusitis (CRS). Although similar symptoms are among the two diseases, AFS has a unique pathophysiology. Patients with AFS demonstrate type 1 hypersensitivity to fungal allergens, increased total serum IgE, increased CD8+ T-cell prevalence, and IL-4 and IL-5 response. Omalizumab should be considered in the treatment of AFS.
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Affiliation(s)
- Martin Oman Evans
- Department of Internal Medicine, San Antonio Uniformed Services Health Education Consortium
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Vashishth A. Extensive Allergic Fungal Rhinosinusitis: Ophthalmic and Skull Base Complications. Indian J Otolaryngol Head Neck Surg 2014; 67:227-33. [PMID: 26405655 DOI: 10.1007/s12070-014-0771-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 08/19/2014] [Indexed: 11/28/2022] Open
Abstract
To review the clinical features, ophthalmic and skull base complications, radiologic correlates, surgical methods and outcomes in cases of extensive allergic fungal rhinosinusitis (AFRS). The retrospective review was carried out at a tertiary referral center and included 11 patients with extensive AFRS. Inclusion criteria were confirmed cases of AFRS with intracranial extension, gross erosion of the skull base or medial orbital wall and/or ophthalmic complications of AFRS, including visual loss. Acute bacterial or invasive fungal sinusitis and other non-AFRS sinus pathologies with orbital or skull base complications were excluded from the study. The mean age of patients was 22.7 years. Proptosis was the most common presenting feature followed by diplopia and visual loss. Four patients exhibited unilateral visual loss with one case of sudden acute onset. Intracranial extradural spread to the middle cranial fossa was observed in two cases with cavernous sinus involvement, destruction of the entire cranial base and extension to the petrous temporal bone. Ten patients exhibited co-existing orbital and skull base erosion whereas gross erosion of the lamina papyracea alone was seen in one patient. All patients underwent endoscopic sinus surgery with complete disease clearance. The minimum and maximum follow-up periods were 1 and 3 years, respectively with one documented recurrence 18 months after surgery. Visual recovery was complete after sudden vision loss whereas it was only partial or absent in patients with prolonged vision loss. Cases of extensive AFRS with ophthalmic and skull base complications pose diagnostic and therapeutic challenges and merit early intervention with long-term follow-up.
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Affiliation(s)
- Ashish Vashishth
- Department of ENT and Head and Neck Surgery, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Welkoborsky HJ, Graß S, Deichmüller C, Bertram O, Hinni ML. Orbital complications in children: differential diagnosis of a challenging disease. Eur Arch Otorhinolaryngol 2014; 272:1157-63. [PMID: 25056021 DOI: 10.1007/s00405-014-3195-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Accepted: 07/02/2014] [Indexed: 10/25/2022]
Abstract
Orbital swelling in children presents diagnostic and therapeutic challenges. Most are associated with acute sinusitis with complicating factors possibly including: amaurosis, meningitis, intracranial abscess or even cavernous sinus thrombosis. However not all acute orbital swelling is associated with acute sinusitis. A careful evaluation is critical prior to initiating therapy. Clinical records of 49 children (27 girls, 22 boys, with an average age of 11.8 years) were retrospectively reviewed. Historical data evaluated included all available information from parents and previous treating physicians. All patients underwent intensive pediatric, ophthalmologic, and otorhinolaryngologic examinations. Computed tomography (CT scans) were additionally performed in 40 % of children. The results of any examinations were also evaluated. Eighteen of the 49 patients had an orbital complication due to acute sinusitis. All 18 had elevated body temperature, C-Reactive Protein (CRP) values and white blood cell counts. Endoscopy of the nose revealed pus in the middle meatus in each case. According to Chandlers' classification, ten children presented with a preseptal, and eight children had a postseptal orbital cellulitis. All patients were admitted to the hospital and treated with intravenous antibiotics. CT scans further demonstrated signs of subperiostal abscess in four children. Functional endoscopic sinus surgery (FESS) was required in six children, including all patients with subperiostal abscess. Twenty children experienced orbital swelling unrelated to acute sinusitis, i.e. atheroma, inflammed insect stings, dental related abscess, conjunctivitis, and Herpes simplex associated superinfection. In three children, acute orbital swelling was caused by an orbital tumor. Orbital complications of an acute sinusitis occur often in the pediatric patient group, and most of these patients can be treated conservative with intravenous antibiotics. Indications for FESS include failure to improve or worsening of clinical symptoms during 24 h of therapy, signs for subperiostal abscess in CT scan, and/or vision loss. Patients with infectous orbital complications had fever, elevated CRP and white blood cell counts. This symptom complex is key in making the correct diagnosis. Interestingly, 61 % of patients in this study demonstrated non-sinusitis related diseases leading to acute orbital swelling, which also required prompt recognition and appropriate therapy.
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Affiliation(s)
- Hans-J Welkoborsky
- Department of Otorhinolaryngology, Head and Neck Surgery, Nordstadt Clinic, Academic Hospital and Childrens' Hospital "Auf Der Bult", Academic Hospital, Haltenhoffstrasse 41, 30167, Hannover, Germany,
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11
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Carifi M, Carifi G. Clinical grading system of orbitopathy secondary to sinus disease. Int Forum Allergy Rhinol 2013; 3:515. [DOI: 10.1002/alr.21152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Marco Carifi
- Department of Otolaryngology; A.O.R.N. “A.Cardarelli,”; Naples; Italy
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