Evaluation of Fungal Diseases of Nose and Paranasal Sinuses in a Rural Tertiary Care Hospital.

Abstract

Aim: Evaluation of Fungal Diseases of nose and paranasal sinuses in a Rural Tertiary Care Hospital.

Materials and Methods: The prospective and observational study was conducted in the Department of ENT, Patna Medical College and Hospital Patna, Bihar from December 2017 to November 2018. Total 100 patients who had clinical features suggestive of fungal infections of nose and paranasal sinuses were evaluated with standard pro forma-haematological investigations, radiological procedures, immunological procedures, and pathological diagnostics formed part of the armamentarium. Surgical management and follow-up were done. Results: Out of 100 patients study, 35% were male and 65 % were female..The majority of cases were in age group between 20-40 years. All patients, in our study, have nasal symptoms 100 (100%). They are nasal obstruction, nasal discharge, postnasal discharge, frequent sneezing, reduced sense of smell (hyposmia) or complete loss of smell (anosmia), and nasal bleeding. Ocular symptoms such as proptosis, epiphora, diplopia blurring of vision in our study were 20%. Fungal culture, in our study, showed out of 100 patients, 33% are Aspergillus flavus, 14 %Aspergillus fumigates, 10 %are Aspergillus niger, 3 %are Aspergillus terreus and 40 were negative. Bilateral disease and involvement of ethmoidal sinus were noted in the majority of cases. Conclusion: About 100% of our series of 100 cases were histopathologically proven to be allergic Aspergillus sinusitis. CT was found to be highly effective for pre-operative evaluation and intraoperative guidance. Nasal polyposis was a concomitant feature in fungal sinusitis.

Key words: Allergic fungal rhinosinusitis, Aspergillus, Endoscopic sinus surgery, Fungal culture, Sinonasal polyposis