[Does allergic fungal sinusitis exist? Preliminary results of a prospective study]. / La sinusite aspergillaire allergique existe-t-elle? Résultats préliminaires d'une étude prospective.

ABSTRACT

Allergic aspergillar sinusitis is a very controversial clinical feature. We present results of a prospective study aimed at evaluating the reality of allergic aspergillar sinusitis in a nosologic and clinical point of vue. During a 5 months period, 31 patients underwent surgery 21 sino-nasal polyposis, 5 chronic sinusitis without polyposis, 5 chronic sinusitis with radiologic images evocative of mycosis. The study was carried out using clinical criteria (per-operative discovery of glue-like, thickened and viscous aspect of the secretions), pathologic criteria (the presence of elements consitutive of allergic mucin), mycological criteria (direct examination and culture), and immunoallergic criteria (specific IgE for Aspergillus fumigatus, serology for Aspergillus fumigatus and Aspergillus flavus (IgM, IgG), skin tests for Aspergillus fumigatus). In three cases we suspect an allergic aspergillar sinusitis (one patient presenting a bilateral chronic sinusitis and two patients presenting a sinonasal polyposis). In two patients presenting a sinonasal polyposis, a allergic fungal sinusitis was suspected, fungal identification was not possible.