Characteristics of bony erosion in allergic fungal rhinosinusitis.
OBJECTIVE
Erosion of bone with or without extension of disease into adjacent anatomic spaces is observed among some patients with allergic fungal rhinosinusitis (AFRS). The objective of this report is to further define these findings as they relate to this disease.


METHODS
Retrospective chart review of 142 patients with AFRS diagnosed using the Bent-Kuhn criteria. All patients were treated at a single institution.


RESULTS
Approximately 20% of patients with AFRS demonstrated bone erosion on CT scan. The ethmoid sinus was the most commonly eroded site. The orbit and anterior cranial fossa were the most common adjacent anatomic spaces to exhibit disease extension. Sinus expansion, not the specific organism identified, was associated with the presence of bone erosion. Surgical management with endoscopic techniques was successful for all patients without any major perioperative complications.


CONCLUSIONS
Bone erosion can be related to AFR. Recognition of this possibility is important because bone erosion can be interpreted as an indication of invasive pathosis. In the presence of bone erosion or disease extension, endoscopic techniques can be used to surgically manage this disease.
Department of Otolaryngology, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd., Dallas, TX 75390-9035, USA.
B
B
Nussenbaum
B F
BF
Marple
N D
ND
Schwade
D001862:Bone Resorption / Q000175:diagnosis* / Q000382:microbiology*; D005005:Ethmoid Sinus / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery; D005626:Frontal Sinus / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery; D006801:Humans; D008443:Maxillary Sinus / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery; D009181:Mycoses / Q000150:complications / Q000382:microbiology*; D012189:Retrospective Studies; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis* / Q000382:microbiology* / Q000601:surgery; D012720:Severity of Illness Index; D012852:Sinusitis / Q000175:diagnosis* / Q000382:microbiology* / Q000601:surgery; D013101:Sphenoid Sinus / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery; D014057:Tomography, X-Ray Computed