一側性副鼻腔炎症例の臨床検討 : ―アレルギー性真菌性鼻副鼻腔炎に着目して―

概要

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We studied the clinical aspects of chronic unilateral sinusitis, including allergic fungal rhinosinusitis (AFRS), newly recognized as intractable and treated by endoscopic sinus surgery (ESS) in Japan. We retrospectively analyzed 128 subjects undergoing ESS for unilateral chronic sinusitis. Subjects were divided into five groups—purulent sinusitis, mycetoma, antrochoanal polyp of the maxillary sinus, AFRS, and suspected AFRS—based on endoscopic findings. Of the 128 cases, 77 involved purulent sinusitis with a good prognosis while 28 involved mycetoma and 17 antrochoanal polyp. Most with mycetoma had a good postoperative prognosis with only endonasal approach. Antrochoanal polyp recurred without complete polyp stalk resection in maxillary sinus—6 cases with AFRS or suspected AFRS showing type 1 fungal allergy and hypereosinophilia in blood examinations. Although less common in Japan than elsewhere, AFRS must be understood as intractable in treating unilateral chronic sinusitis with type 1 fungal allergy.