Allergic fungal rhinosinusitis with skull base destruction
Main Article Content
Abstract
Allergic fungal sinusitis is an inflammatory disease of the rhinosinusal mucosa caused by fungi that can be isolated from the nasal cavity of healthy individuals.
The pathology is produced indirectly by the fungus that acts as an antigen and triggers an IgE-mediated allergic reaction that causes polyps and a thick mucous discharge with detritus and hyphae called mucin.
Its most common clinical presentation is unilateral or bilateral chronic sinusitis with polyps.
Less commonly, substances originated by the degranulation of eosinophils cause bone remodeling or destruction, and sinusitis can simulate a neoplasia.
We describe the clinical case of a patient who suffered from allergic fungal sinusitis with massive bone destruction of the skull base and who had intracranial, extradural and intraorbital extension of the disease. He was successfully treated with surgery and corticosteroids.
Downloads
Article Details
Section

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
How to Cite
References
Saravanan K, Panda NK, Chakrabarti A, et al. Allergic fungal rhinosinusitis: an attempt to resolve the diagnostic dilemma. Arch Otolaryngol Head Neck Surg. 2006;132(2):173-178. https://doi.org/10.1001/archotol.132.2.173. DOI: https://doi.org/10.1001/archotol.132.2.173
Ponikau JU, Sherris DA, Kern EB, et al. The diagnosis and incidence of allergic fungal sinusitis. Mayo Clin Proc. 1999;74(9):877-884. https://doi.org/10.4065/74.9.877. DOI: https://doi.org/10.4065/74.9.877
Bent JP 3rd, Kuhn FA. Diagnosis of allergic fungal sinusitis. Otolaryngol Head Neck Surg. 1994;111(5):580-588. https://doi.org/10.1177/019459989411100508. DOI: https://doi.org/10.1177/019459989411100508
Marple BF. Allergic fungal rhinosinusitis: current theories and management strategies. Laryngoscope. 2001;111(6):1006-1019. https://doi.org/10.1097/00005537-200106000-00015 . DOI: https://doi.org/10.1097/00005537-200106000-00015
Alaraj AM, Al-Faky YH, Alsuhaibani AH. Ophthalmic manifestations of allergic fungal sinusitis. Ophthalmic PlastReconstr Surg. 2018;34(5):463-466. https://doi.org/10.1097/IOP.0000000000001051. DOI: https://doi.org/10.1097/IOP.0000000000001051
Marfani MS, Jawaid MA, Shaikh SM, et al. Allergic fungal rhinosinusitis with skull base and orbital erosion. J Laryngol Otol. 2010 Feb;124(2):161-165. https://doi.org/10.1017/S0022215109991253. DOI: https://doi.org/10.1017/S0022215109991253
Tyler MA, Luong AU. Current concepts in the management of allergic fungal rhinosinusitis. Immunol Allergy Clin North Am. 2020;40(2):345-359. https://doi.org/10.1016/j.iac.2019.12.001. DOI: https://doi.org/10.1016/j.iac.2019.12.001
Rojita M, Samal S, Pradhan P, et al. Comparison of steroid and itraconazole for prevention of recurrence in allergic fungal rhinosinusitis: a randomized controlled trial. J ClinDiagn Res. 2017;11(4):MC01-MC03. https://doi.org/10.7860/JCDR/2017/23488.9610. DOI: https://doi.org/10.7860/JCDR/2017/23488.9610
Chan KO, Genoway KA, Javer AR. Effectiveness of itraconazole in the management of refractory allergic fungal rhinosinusitis. J Otolaryngol Head Neck Surg. 2008;37(6):870-874. PMID: 19128719.
Medikeri G, Javer A. Optimal management of allergic fungal rhinosinusitis. J Asthma Allergy. 2020;13:323-332. https://doi.org/10.2147/JAA.S217658 . DOI: https://doi.org/10.2147/JAA.S217658
Gan EC, Habib AR, Rajwani A, et al. Omalizumab therapy for refractory allergic fungal rhinosinusitis patients with moderate or severe asthma. Am J Otolaryngol. 2015;36(5):672-677. https://doi.org/10.1016/j.amjoto.2015.05.008. DOI: https://doi.org/10.1016/j.amjoto.2015.05.008