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Article Type

Article

Abstract

Aim: Allergic fungal rhinosinusitis (AFRS) is a distinct clinical and pathological entity. Various recurrence rates have been reported in literature, but the contralateral disease development in unilateral AFRS cases has not been specifically investigated. The aim of the current study was to analyze the outcomes in unilateral cases of AFRS.

Setting and design: This is a retrospective analysis conducted at a tertiary care institution.

Patients and methods: We have conducted a retrospective review of all patients who underwent endoscopic sinus surgery from January 2012 to March 2015 at our institution. AFRS patients’ demographics, diagnosis, management, and follow-up data were collected.

Statistical analysis: Analyses were performed using IBM SPSS 22.0 for Windows. The prevalence of AFRS and unilateral AFRS was calculated. In case of unilateral AFRS, further descriptive analysis was performed.

Results: AFRS was diagnosed in 52 (38.2%) out of 136 cases of chronic rhinosinusitis with or without nasal polyps treated with endoscopic sinus surgery. Out of the 52 AFRS patients, 16 (30.8%) cases presented with unilateral AFRS, and all were treated with standard surgical and medical therapy. During a mean follow-up of 24.8 months, nine (56.2%) of the 16 unilateral cases remained disease-free, four (25%) developed AFRS on the contralateral side, two (12.5%) had recurrent ipsilateral AFRS, and one (6.25%) had both ipsilateral recurrence and contralateral development of AFRS.

Conclusion: Postoperative development of contralateral disease in unilateral AFRS cases is not uncommon, and it frequently occurs even without involvement of the originally operated side. These findings require special attention in patients’ management, follow-up, and counseling.

Keywords: bilateral disease, chronic sinusitis, contralateral development, endoscopic sinus surgery, follow-up, laterality, predominant nasal polyps, prevalence, recurrence rate, sinonasal polyposis

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