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Article Type

Original Study

Abstract

Background Proper eradication of allergic fungal sinusitis (AFS) depends on three factors: first is proper preoperative evaluation and mapping via computed tomography and MRI. Second is the availability of adequate surgical tools in experienced hands. Third is the proper postoperative endoscopic follow-up to detect and remove recurrence if possible. Aim To evaluate the role of inferior turbinectomy (IT) and partial middle turbinectomy (PMT) in patients with AFS managed by endoscopic sinus surgery (ESS) for the prevention of recurrence and adequate management of residual disease (postoperative salvage). Patients and methods A prospective, comparative, randomized study conducted from March 2016 to April 2018. In all, 28 patients suffering from AFS were included. All patients have been presented and managed at the Department of Otolaryngology, Hearing and Speech Institute. Patients have been randomized into two groups of 14 patients each (groups A and B). The patients in group A have undergone ESS only, while the patients in group B have undergone ESS plus bilateral IT and PMT. Regular follow-up visits were done every 2 months for at least 6 months for both groups. Results In group A, there was difficulty in proper assessment in 11 patients out of 14. Recurrence occurred in five patients who showed rigorous assessment, which was managed via ESS adding to the maneuver bilateral IT and PMT. In group B, only two patients were difficult out of the 14. Recurrence occurred in two patients only and was managed easily in the outpatient office. No significant complications were detected in both groups. Conclusion IT and PMT may be considered as essential steps in the surgery for AFS as they play a role in lowering the recurrence rate and facilitating better, more comfortable, and more effective postoperative management of recurrence if happened.

Keywords

Allergic fungal sinusitis, inferior turbinectomy, partial middle turbinectomy

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