Objectives:

In the present study we aimed to investigate the presence of AFS in patients who had undergone sinus surgery.

Materials and Methods:

77 patients who have undergone functional endoscopic sinus surgery (FESS) were included. Patients with neoplasia were excluded. Anterior rhinoscopy and nasal endoscopy were performed as well as routine ENT examination. Sinus computed tomographies were taken. Peripheric blood eosinophil count, total and specific IgE were measured. Peroperative sinus aspirates and surgical materials were invesitigated both microbiologically and histopathologically.

Results:

AFS was diagnosed in 7 (9,09%) patients. In the light of PNS CT scans, 5 (71,4%) of 7 AFS patients had radiologically detected polips. Peripheral blood eosinophilia and increased total IgE levels were detected in 22 (28,57%) cases and 12 (15,58%) cases respectively. Although skin prick test positivity against fungal antigens was recognised in 12 (15,58%) of cases, specific IgE positivity wasnot present. Peroperative PNS aspirates were similar with the glue-like material (allergic mucin) macroscopically in 36 (46,8%) patients. Except the presence of macroscopic allergic mucin (p:0,003), mycological culture positivity (p:0,000) and histopathological hyphae (p:0,000), which are also diagnostic criteria; there was no significant difference between two groups. With respect to variables such as sex, history of atopy, asthma, ASA intolerance, polip and the number of sinus involvement. Similarly no significant difference was detected between two groups with regard to eosinophilia, IgE level, prick test positivity, presence of allergic mucin and sinus operation history.

Conclusion:

Patients suspected to have AFS should be evaluated with radiological, immunological, microbiological and histopathological methods beyond examination.

Keywords: Allergic fungal sinusitis, FESS operation