title: [Diagnosis and treatment of unilateral allergic fungal sinusitis].
abstract: OBJECTIVE
  To investigate the clinical and pathological manifestation, prognosis of unilateral allergic fungal sinusitis (AFS), and to analyze the characters and treatment paradigm of unilateral AFS.
  
  
  METHODS
  Clinical and pathological information of 10 cases of unilateral AFS were analyzed. Nasal endoscopy, skin prick test, and visual analogue score (VAS) of severity of illness were taken before surgery. Mucosa membrane and inspissated secretion obtained during endoscopic surgery were stained with hematoxylin-eosin and silver hexosamine. Regular clean of sinus and intranasal steroid spray were taken after surgery.
  
  
  RESULTS
  Endoscopy showed that 5 cases had pale mucous membranes in the ipsilateral nasal cavity. Skin prick test was positive in all patients. Nasal CT scan demonstrated unilateral lesion in all 10 patients. In the involved sinus, all 10 patients had brown or yellow brown viscous secretion, which demonstrated eosinophilic amorphous mass with accumulation of eosinophils, Charcot-Leyden crystallization and fungal hyphae under microscope. The number of eosinophils in lamina propria of sinus mucosa membrane was 72 +/- 11/hpf. After follow-up for 16 to 26 months(mean 22 months), 9 cases were cured and 1 improved. The pre-operative VAS was 8.5 +/- 1.2, and the post-operative VAS was 1.1 +/- 1.0 (P < 0.01).
  
  
  CONCLUSIONS
  The systemic and local allergic reaction may co-exist in unilateral AFS, in which local hypersensitivity may be the dominant reaction. Endoscopic sinus surgery and intranasal steroid spray are effective in the treatment of unilateral AFS.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Xijing Hospital, the Fourth Military Medical University, Xi'an, 710032, China. chenfq2@yahoo.com
authors.forename: Fuquan
authors.initials: F
authors.lastname: Chen
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Xijing Hospital, the Fourth Military Medical University, Xi'an, 710032, China.
authors.forename: Min
authors.initials: M
authors.lastname: Xu
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Xijing Hospital, the Fourth Military Medical University, Xi'an, 710032, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Xijing Hospital, the Fourth Military Medical University, Xi'an, 710032, China.
authors.forename: Yani
authors.initials: Y
authors.lastname: Feng
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Xijing Hospital, the Fourth Military Medical University, Xi'an, 710032, China.
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Shi
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Xijing Hospital, the Fourth Military Medical University, Xi'an, 710032, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Xue
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Xijing Hospital, the Fourth Military Medical University, Xi'an, 710032, China.
authors.forename: Li
authors.initials: L
authors.lastname: Qiao
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Xijing Hospital, the Fourth Military Medical University, Xi'an, 710032, China.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Qiu
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis / Q000628:therapy; D065631:Rhinitis, Allergic; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D012852:Sinusitis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy