title: Radiologic staging system for allergic fungal rhinosinusitis (AFRS).
abstract: OBJECTIVE
  1) Develop an objective method for quantifying radiologic bone erosion in allergic fungal rhinosinusitis (AFRS); and 2) assess the utility of the new CT scan staging system in differentiating AFRS patient groups.
  
  
  METHODS
  Patients from two tertiary care rhinology practices with AFRS and available CT scans (1999-2007) were included for review by trained graders. The following novel assessment scale was used: Each paranasal sinus wall with expansion/erosion was scored 1 point, with maximum 3 points possible for each frontal sinus, 2 points for each ethmoid complex, 3 points for each sphenoid sinus, 3 points for each maxillary sinus, and 1 point each for the frontal and sphenoid intersinus septae, yielding maximum of 24 possible points.
  
  
  RESULTS
  A total of 111 CT scans were reviewed. Mean score was 7.8 (range, 0-24). Males scored significantly higher than females (mean, 9.3 vs 5.6, P = 0.001). African Americans scored significantly higher than Caucasians (mean, 9.6 vs 5.0, P < 0.001).
  
  
  CONCLUSIONS
  A scoring system for bone remodeling in AFRS is presented. Males and African-Americans with AFRS demonstrate significantly more bone erosion. Additional analysis of disease course will assess the utility of this staging system in predicting outcomes.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Emory University, Atlanta, GA, USA. sarah.wise@emoryhealthcare.org
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Wise
authors.forename: Gamwell A
authors.initials: GA
authors.lastname: Rogers
authors.forename: Mark D
authors.initials: MD
authors.lastname: Ghegan
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Harvey
authors.forename: John M
authors.initials: JM
authors.lastname: Delgaudio
authors.forename: Rodney J
authors.initials: RJ
authors.lastname: Schlosser
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001850:Bone Diseases, Infectious / Q000000981:diagnostic imaging* / Q000382:microbiology; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000000981:diagnostic imaging* / Q000382:microbiology; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging / Q000382:microbiology; D012221:Rhinitis, Allergic, Perennial / Q000000981:diagnostic imaging* / Q000382:microbiology; D012852:Sinusitis / Q000000981:diagnostic imaging* / Q000382:microbiology; D014057:Tomography, X-Ray Computed