Allergic Fungal Sinusitis Report of Three Cases Associated with Dematiaceous Fungi
|
|
- Audra Horton
- 6 years ago
- Views:
Transcription
1 CLINICAL MICROBIOLOGY Original Article Report of Three Cases Associated with Dematiaceous Fungi GLEN C. FRIEDMAN, M.D., 1 R. WARREN J. HARTWICK, M.D., F.R.C.P.C., 1 JAE Y. RO, M.D., 1 GEORGE Y. SALEH, M.D., 1 JEFFREY J. TARRAND, M.D., 2 AND ALBERTO G. AY ALA, M.D. 1 Most reported cases of allergic sinusitis have been attributed to Aspergillus, based on the morphologic features of the organisms in tissue sections. However, in most cases, cultures have not been done. This is a report of three cases of non-aspergillus allergic fungal sinusitis. The patients' ages were 11,16, and 43; two were male and one was female. Histopathologic study disclosed fungal organisms resembling Aspergillus. However, cultures of these patients' nasal secretions grew Drechslera, Exserohilum, and Bipolaris fungal organisms. The non-aspergillus nature of these infections was further supported by positive Fontana-Masson melanin staining. The authors conclude that allergic fungal sinusitis most likely results from non- Aspergillus organisms. For definitive fungal identification, tissue culture is mandatory. When tissue is not cultured or no organisms grow, a Fontana-Masson stain can be a useful adjunct in fungal identification. (Key words: Aspergillus; Drechslera; Exserohilum; Bipolaris; Allergic sinusitis; Fontana-Masson stain) Am J Clin Pathol 1991;96: Fungal infections of the nasal cavity and paranasal sinuses may take four different clinicopathologic forms. 1 " 3 Two of these forms, chronic indolent infections and invasive fulminant infections, are tissue invasive, whereas the other two forms, mycetoma and allergic "Aspergillus" sinusitis, are saprophytic and noninvasive. Allergic Aspergillus sinusitis was described recently by Katzenstein and associates 4 " 6 and is characterized by mucus impaction of sinuses, bone destruction, and a history of asthma. Based on fungal hyphal morphologic characteristics in tissue sections and serologic findings, these authors attributed allergic fungal sinusitis (AFS) to Aspergillus However, of 30 reported cases, only 4 were proven by culture to result from Aspergillus. Furthermore, studies in which fungal cultures were used have documented several different fungi, including Aspergillus, 13,7 Curvularia, 8,9 and the dematiaceous fungi Drechslera, Bipolaris, and Exserohilum. 10 " 14 In this report we will describe the clinical, pathologic, and mycologic features of allergic fungal non-aspergillus From the Departments of 1 Pathology and laboratory Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas. Received November 1, 1990; received revised manuscript and accepted for publication January 17, Address reprint requests to Dr. Ayala: Department of Pathology, Box 85, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas sinusitis in three patients and review the pertinent literature. Case 1 REPORT OF THREE CASES An 11-year-old boy had a six-month history of nasal obstruction and discharge, right periorbital swelling, and decreased vision in his right eye. During this period, antihistaminic decongestant and antibiotic treatment had been ineffective. The patient had a history of seasonal (winter) bronchial asthma, for which he took theophylline. Examination showedrightproptosis and palpable swelling in the region of the right medial canthus. Also, a mass was observed within the right nasal cavity, extending from the middle meatus. Laboratory investigations showed a normochromic, normocytic anemia with a normal total white blood cell count and normal eosinophil levels. Computed tomographic (CT) scan and magnetic resonance imaging showed a soft-tissue mass occupying the right nasal cavity, maxillary and ethmoid sinuses, and sphenoid sinus. There was evidence of erosion of surrounding bones. The patient underwent a right Caldwell-Luc operation on the nasalantral window plus a right external ethmoidectomy and sphenoidectomy and drainage of the sinuses. Exserohilum grew from culture of sinus tissue. Follow-up at eight months revealed CT evidence of persistent mucosal thickening in the ethmoid, sphenoid, and maxillary sinuses; however, there were no expansile masses in the sinonasal areas. Case 2 A 16-year-old girl presented with nasal discharge, obstruction of the left nasal cavity, and nasal polyposis. A nasal polypectomy plus a nasalantral window were performed. Culture of the sinus contents revealed Cladosporium organisms. Fourteen months later, the patient had recur- 368
2 FRIEDMAN ET AL. 369 rent nasal symptoms and underwent allergic desensitization. Fourteen months after that, she had recurrent symptoms again. CT scan revealed pansinusitis with involvement of the sella turcica. The patient underwent nasal polypectomy, septoplasty, and intranasal ethmoidal debridement. Culture of the sinus contents revealed Drechslera organisms. The patient then was referred to M. D. Anderson Cancer Center and underwent bilateral Caldwell-Luc procedures with drainage of the maxillary, ethmoid, and sphenoid sinuses. At surgery, the right planum sphenoidalis, anterior sella turcica, and clivus were noted to have been destroyed, although the dura was intact. The patient was discharged while being treated with ketoconazole. Follow-up studies at one year showed persistent radiologic opacification of the maxillary and ethmoid sinuses. Case 3 A 43-year-old man had a two-year history of increasing nasal obstruction and a one-month history of diplopia. He had no known allergies. Examination revealed a "fleshy" lesion of the right nasal cavity that extended through the septum into the left nasal cavity. CT scan revealed opacification of the ethmoid and anterior sphenoid sinuses and the nasal cavities, with erosion of the clivus. The patient underwent bilateral external ethmoidectomy, maxillectomy, sphenoidectomy, and frontal sinusotomy. Bipolaris species grew from culture of sinus tissue. MATERIALS AND METHODS Three recent cases at the surgical pathology division of M. D. Anderson Cancer Center were reviewed in our study. Clinical histories were retrieved from the medical record charts, and all formalin-fixed, paraffin-embedded, hematoxylin and eosin (H and E)-stained sections were examined for routine histologic evaluations. Representative sections also were stained with Gomori methenamine-silver (GMS) stain, Gram's stain, and Fontana- Masson stain. All three patients' paranasal sinus contents were submitted for fungal culture at the time of surgery. All three specimens were obtained aseptically, transported in sterile saline-moistened gauze, ground, emulsified, and cultured on mold-inhibitory agar and Sabouraud dextrose agar at 30 C. The molds grew after two weeks and were brown or black with a black, pigmented back surface. The fungi were identified with the use of the microslide culture technique. Finally, the clinical, pathologic, and mycologic findings were correlated with findings from the previously reported cases. Gross Pathology RESULTS The gross pathologic features were similar in the three cases. Specimens consisted of fragments of pink-tan mucosa and thick red-gray to green-brown mucoid material. Histology The histologic features were similar in all three cases. The fragments of mucosa were edematous and contained acute and chronic inflammatory cells. Adjacent to the mucosa, there was thick basophilic mucinous material containing large numbers of inflammatory cells and necrotic debris. The inflammatory cells predominantly were eosinophils and neutrophils, with lesser numbers of plasma cells, histiocytes, and lymphocytes. Basophilic laminations were seen within the necrotic material (Fig. 1). Scattered among the eosinophils were Charcot-Leyden crystals, which stained purple with Gram's stain. In all three cases, isolated fungal hyphae were scattered through the mucus in the GMS- and Fontana-Masson-stained sections (Fig. 2). Because the Fontana-Masson stain showed a clean background, it identified the fungal organisms better than did the GMS stain. Fungi were not aggregated into fungal balls. The fungal hyphae showed dichotomous branching and had moderately irregular contours, giving a geniculate or "toruloid" appearance. The hyphae measured 4-9 j^m in width and contained faint horizontal lines suggesting septation (Fig. 3). At the ends of occasional hyphae, round to oval conidia were identified. Hyphal morphologic characteristics in histologic sections could not differentiate these organisms reliably from comparable cases of aspergillosis. No fungi were seen in the mucosal tissue fragments. Fungal Cultures Material submitted from cases 1-3 grew fungi consistent with Exserohilum, Drechslera, and Bipolaris, respectively. These molds took three days to two weeks to grow. The Exserohilum species demonstrated fusoid conidia with a distinct protruding thickened truncate hilum. The Bipolaris species had more ellipsoidal conidia with less prominent truncate hila. Our Drechslera species isolated in 1983 could not be recovered for reidentification. Identification of Drechslera species was confirmed later by the Centers for Disease Control (CDC) as Drechslera spicifera; however, significant taxonomic changes have occurred since Conidia of Exserohilum, Bipolaris, and Drechslera species are all sympodial in arrangement. Conidia of Drechslera and Bipolaris are very similar morphologically. All species had brown to black colony color from the reverse surface. DISCUSSION In 1976, Safirstein 15 reported a case of allergic bronchopulmonary aspergillosis in association with nasal plugs and sinusitis. The sinus contents grew Aspergillus fumigatus on culture. However, the histologic features of the sinonasal contents were not described. In 1978, Young and associates 14 reported a case of chronic nasal obstruction and sinusitis with sinoorbital bone erosion in which Drechslera hawaiiensis was cultured. In 1983, Katzenstein and colleagues 4,5 described seven patients with nasal pol- Vol. 96 No. 3
3 370 CLINICAL MICROBIOLOGY Original Article» 1.1 / > *. «f- ' '.* 4 'it. AJ.C.P.-September 1991
4 FRIEDMAN ET AL. 371 FIG. t (upper). A. Basophilic laminations within the necrotic material. Hematoxylin and eosin (X40). B. Mucin contains necrotic debris and many inflammatory cells (predominantly eosinophils). Hematoxylin and eosin (X250). FIG. 2 (lower). Both GMS (A) and Fontana-Masson (B) stains demonstrate scattered fungal hyphae (X250). yps and sinusitis in whom Aspergillus was suspected to be a contributing factor. Fungal hyphae identified in histologic sections of sinus mucin and elevated level of serum total IgE or serum precipitins to A. fumigatus were cited as supporting evidence for their hypothesis. Since then, the allergic form of saprophytic fungal disease affecting the nasal sinuses and lower respiratory tract is referred to most often in the medical literature as allergic Aspergillus sinusitis. However, of 30 reported cases, 2-616,17 only 4 were proven by culture to result from Aspergillus. 1 " 3 The remaining 26 were attributed to Aspergillus on the basis of fungal morphologic characteristics in GMSstained tissue sections and elevated serum levels of IgE and precipitins to A. fumigatus. In recent years, the sinus contents were cultured from a small number of cases that fulfilled the clinical and pathologic criteria for allergic Aspergillus sinusitis. In most of these cases, fungal organisms other than Aspergillus were identified. To date, there are reports of two cases resulting from Bipolaris, 10,11 one from Exserohilum, 10 two from Drechslera, 12 " 14 and three from Curvularia. 8,9 The species of Drechslera, Bipolaris, and Exserohilum all are considered to be dematiaceous fungi. These "darkly pigmented" fungi are so-named because their colonies appear brown, dark green, or black with a black reverse. These organisms have septate hyphae that, in tissue sections, may mimic Aspergillus. In fact, in the above-mentioned non-aspergillus cases, the hyphae were described '% 1 ^ y }J : S FIG. 3. The fungal hyphae show dichotomous branching with occasional septae. Fontana-Masson (X400). V 0 as septate in all but one case. In one case, the hyphae were described as "resembling Mucor." Although positive staining with GMS highlights the presence of fungal organisms, it does not aid in distinguishing dematiaceous fungi from Aspergillus or Zygomycetes. A Fontana-Masson melanin stain, however, can help one distinguish dematiaceous fungi from other classes of septate fungi (except in the case of Aspergillus niger, a pigmented species of Aspergillus). 18 The pigment produced by dematiaceous fungi is similar to melanin and stains positively with the Fontana-Masson melanin stain. The three cases in our study stained with Fontana-Masson, as well as with GMS stain. Moreover, we noticed that the Fontana-Masson stain demonstrated the presence of fungal organisms more clearly than did the GMS stain. This finding resulted from clearer background staining with Fontana-Masson. Therefore, the Fontana-Masson stain is an alternative diagnostic method that may be used in cases of infection by hyphae-forming organisms morphologically suggestive of Aspergillus or Mucor. The morphologic similarity of dematiaceous fungi to each other makes speciation difficult. In fact, many previously reported Drechslera infections actually may have been Bipolaris or Exserohilum infections. 19 Recently, however, virtually all isolates that previously were called Drechslera, and which are associated with human disease, now have been reclassified as Bipolaris or Exserohilum. 20 Although these cases of allergic sinusitis result from several fungal species, including Aspergillus, the clinicopathologic features are very similar in all of the cases reported. To date, at least 44 cases of AFS, including the current cases, have been reported. 1 ' 3 " ,21,22 The patients included 24 women and 19 men; in one case, the patient's sex was not stated. Patient age at diagnosis ranged from 8 to 56 years (mean, 26 years; median, 21 years). Twenty-two (50%) of the patients had a history of allergies, rhinitis, or asthma. In most cases, multiple sinuses were involved, and the maxillary and ethmoid sinuses were affected most often. Clinical or radiographic evidence of sinoorbital bone erosion was seen in approximately onethird of all patients. All six pediatric patients reported by Manning and associates had facial deformity secondary to expansile sinusitis. 17 The characteristic pathologic features of AFS were demonstrated in all of the cases. The material evacuated from the sinuses was thick, inspissated, yellow-green mucus. Histologically, the most characteristic feature was "allergic mucin," described by Katzenstein and associ- Vol. 96 No. 3
5 372 CLINICAL MICROBIOLOGY Article ates. 4,5 The mucin is basophilic or slightly eosinophilic and has a laminated or layered appearance resulting from densely packed bands of inflammatory cells (predominantly eosinophils), sloughed respiratory epithelial cells, cell debris, and Charcot-Leyden crystals alternating with less cellular mucinous material (see Fig. 1). Charcot-Leyden crystals, formed from aggregated eosinophil granules, appear hexagonal in cross-section or rectangular or bipyramidal in longitudinal section. The crystals appear bright purple in gram-stained sections. Fungal hyphae also are present in the mucin but usually are not numerous. Dematiaceous fungi have a branched appearance similar to that of Aspergillus and are well visualized in GMS- and Fontana-Masson-stained sections. The variability in appearance and presence of unusual forms may result from degenerative changes. The three cases in our study showed features that were identical pathologically to those described in the literature, including tenacious mucinous material containing inflammatory cells (predominantly eosinophils), necrotic debris, and occasional scattered fungal hyphae. Surgical treatment of AFS consists of debridement of the fungus and mucus, restoration of mucociliary sinonasal drainage, and sinus ventilation. Adjuvant corticosteroids have been used in a few cases, although a clinical trial has not been conducted. Although antifungal agents have been used in a few reported cases, generally they are not considered necessary when fungus has not invaded the tissue. 123 The pathogenesis of AFS is not known, although a combination of type I (IgE) and type III (immune complex) hyperreactivity to fungal antigens has been proposed.' 23 A similar pathophysiology has been proposed for allergic bronchopulmonary aspergillosis. The lack of bronchopulmonary disease in the reported cases of AFS suggests that other factors may play a role in the pathogenesis of these two conditions. It is suspected that susceptible people become infected more often in warm, humid climates. In conclusion, the allergic noninvasive form of fungal disease in the paranasal sinuses is a distinct clinicopathologic entity caused by diverse fungal organisms. Recognition of the pathologic features is important in distinguishing it from other causes of sinonasal obstruction or radiographic opacification, including invasive fungal infection and neoplasia. Allergic fungal infection of the paranasal sinuses may be caused by several species of fungus. Therefore, we recommend culture as a more definitive means of fungal identification than the subjective evaluation of hyphae in tissue sections. Because Aspergillus is not the only organism to cause allergic sinusitis, we recommend that the entity be referred to as "allergic fungal sinusitis" rather than "allergic Aspergillus sinusitis." Acknowledgments. The authors thank Elsa Ramos for photographic assistance and Bobbie Coleman for typing the manuscript. REFERENCES 1. Goldstein MF, Atkins PC, Cogen FC, Kornstein MJ, Levine RS, Zweiman B. Allergic Aspergillus sinusitis. J Allergy Clin Immunol 1985;76: Hartwick RW, Batsakis JG. Sinus aspergillosis and allergic fungal sinusitis. Ann Otol Rhinol Laryngol (in press). 3. Philip G, Keen CE. Allergic fungal sinusitis. Histopathology 1989; 14: Katzenstein A-LA, Sale SR, Greenberger PA. Allergic Aspergillus sinusitis: a newly recognized form of sinusitis. J Allergy Clin Immunol 1983;72: Katzenstein A-LA, Sale SR, Greenberger PA. Pathologic findings in allergic Aspergillus sinusitis: a newly recognized form of sinusitis. Am J Surg Pathol 1983;7: Waxman JE, Spector JG, Sale SR, Katzenstein A-L. Allergic Aspergillus sinusitis: concepts in diagnosis and treatment of a new clinical entity. Laryngoscope 1987;97: Jonathan D, Lund V, Milroy C. Allergic Aspergillus sinusitis: an overlooked diagnosis? J Laryngol Otol 1989; 103: Brummund W, Kurup VP, Harris GJ, Duncavage JA, Arkins JA. Allergic sino-orbital mycosis: a clinical and immunologic study. JAMA 1986;256: Macmillan RH III, Cooper PH, Body BA, Mills AS. Allergic fungal sinusitis due to Curvularia lunata. Hum Pathol 1987; 18: Adam RD, Paquin ML, Petersen EA, et al. Phaeohyphomycosis caused by fungal genera Bipolaris and Exserohilum: a report of 9 cases and review of the literature. Medicine 1986;65: Robson JMB, Benn RAV, Hogan PG, Gatenby PA. Allergic fungal sinusitis presenting as a paranasal sinus tumour. Aust NZ J Med 1989;19: Rolston KVI, Hopfer RL, Larson DL. Infections caused by Drechslera species: case report and review of the literature. Rev Infect Dis 1985;7: Sobol SM, Love RG, Stutman HR, PysherTJ. Phaeohyphomycosis of the maxilloethmoid sinus caused by Drechslera spicifera: a new fungal pathogen. Laryngoscope 1984;94: Young CN, Swart JG, Ackermann D, Davidge-Pitts K. Nasal obstruction and bone erosion caused by Drechslera hawaiiensis. J Laryngol Otol 1978;92: Safirstein B. Allergic bronchopulmonary aspergillosis with obstruction of the upper respiratory tract. Chest 1976;70: Jackson IT, Schmitt E III, Carpenter HA. Allergic Aspergillus sinusitis. Plast Reconstr Surg 1987;79: Manning SC, Vuitch F, Weinberg AG, Brown OE. Allergic aspergillosis: a newly recognized form of sinusitis in the pediatric population. Laryngoscope 1989;99: Anaissie E, Bodey GP, Kantarjian H, et al. New spectrum of fungal infection in patients with cancer. Rev Infect Dis 1989; 11: McGinnis MR. Human pathogenic species of Exophiala, Phialophora and Wangiella in the black and white yeasts. Scientific publication, no Washington, D.C.: Pan American Health Organization, 1978: McGinnis MR, Rinaldi MG, Winn RE. Emerging agents of phaeohyphomycosis: pathogenic species of Bipolaris and Exserohilum. J Clin Microbiol 1986;24: Milroy CM, Blanshard JD, Lucas S, Michaels L. Aspergillosis of the nose and paranasal sinuses. J Clin Pathol 1989;42: Stammberger H, Jaske R, Beaufort F. Aspergillosis of the paranasal sinuses: X-ray diagnosis, histopathology, and clinical aspects. Ann Otol Rhinol Laryngol 1984;93: Walsh TJ, Dixon DM. Nosocomial aspergillosis: environmental microbiology, hospital epidemiology, diagnosis and treatment. Eur J Epidemiol 1989;5: A.J.C.P.
Mucin-Related Rhinosinusitis YOUSEF ALJATHLANY ORL-HNS RESIDENT
Mucin-Related Rhinosinusitis YOUSEF ALJATHLANY ORL-HNS RESIDENT Free PPT Click to add title This PowerPoint Template has clean and neutral design that can be adapted to any content and meets various market
More informationRecovery of non-invasive Aspergillus sinusitis by endoscopic sinus surgery*
Rhinology, 35, 84 88, 1997 Recovery of non-invasive Aspergillus sinusitis by endoscopic sinus surgery* Sheen-Yie Fang Department of Otolaryngology, Faculty of Medicine, National Cheng Kung University,
More informationOutline. Sinonasal Endoscopic Surgery 6/1/2011
Kathleen Kthl T. Montone, M.D. Department of Pathology and Laboratory Medicine University of Pennsylvania Outline Evaluation of sinonasal ethmoidectomy specimens. Overview of Sinonasal fungal diseases
More informationControversies surrounding categorization of fungal sinusitis
Controversies surrounding categorization of fungal sinusitis Arunaloke Chakrabarti Professor,Department of Medical Microbiology Center for Advanced Research in Medical Mycology Postgraduate Institute of
More informationIs the Classical Classification of Aspergillosis of the Paranasal Sinuses to non invasive and invasive still valid or not?
Bahrain Medical Bulletin, Vol.24, No.3, September 2002 Is the Classical Classification of Aspergillosis of the Paranasal Sinuses to non invasive and invasive still valid or not? Abdul Aziz Ashoor (FA-HNO)*
More informationIntroduction. Study of fungi called mycology.
Fungi Introduction Study of fungi called mycology. Some fungi are beneficial: ex a) Important in production of some foods, ex: cheeses, bread. b) Important in production of some antibiotics, ex: penicillin
More informationRhinosinusitis: Current Concepts. Frederick S. Rosen, MD Matthew Ryan, MD
Rhinosinusitis: Current Concepts Frederick S. Rosen, MD Matthew Ryan, MD Introduction 2 Introduction The medical condition most commonly reported by US Census Department Major Factors: Facial pain/pressure,
More informationRhinosinusitis. John Ramey, MD Joseph Russell, MD
Rhinosinusitis John Ramey, MD Joseph Russell, MD Disclosure Statement RSFH as a continuing medical education provider, accredited by the South Carolina Medical Association, it is the policy of RSFH to
More informationAllergic fungal rhinosinusitis: A review of clinical manifestations and current treatment strategies
Medical Mycology September 2006, 44, S277 S284 Allergic fungal rhinosinusitis: A review of clinical manifestations and current treatment strategies BRADLEY F. MARPLE Department of Otolaryngology, Head
More informationMycology. BioV 400. Subcutaneous Mycoses. Ecological associations. Geographic distribution World-wide
BioV 400 Mycology Handout 8 Subcutaneous Mycoses Lymphocutaneous sporotrichosis Chromoblastomycosis Phaeohyphomycosis Zygomycosis Mycetoma Lymphocutaneous sporotrichosis Sporothrix schenckii Chronic infection
More informationFungal ball.. Clinical and radiological features DR. AHMED ALTUWAIJRI 1/5/2017
Fungal ball.. Clinical and radiological features DR. AHMED ALTUWAIJRI 1/5/2017 Fungal Rhinosinusitis (FRS) Rhinosinusitis, is a common disorder affecting approximately 20% of the population at some time
More informationAllergic Fungal Rhinosinusitis Involving Frontal Sinus: A Prospective Study comparing Surgical Modalities
10.5005/jp-journals-10013-1141 H Verma et al ORIGINAL ARTICLE Allergic Fungal Rhinosinusitis Involving Frontal Sinus: A Prospective Study comparing Surgical Modalities H Verma, Rijuneeta, AK Gupta, A Chakrabarti
More informationCase Report Chronic Invasive Nongranulomatous Fungal Rhinosinusitis in Immunocompetent Individuals
Case Reports in Otolaryngology Volume 2016, Article ID 6854121, 7 pages http://dx.doi.org/10.1155/2016/6854121 Case Report Chronic Invasive Nongranulomatous Fungal Rhinosinusitis in Immunocompetent Individuals
More informationPathologic Features of Non-Invasive Fungal Rhinosinusitis
The Open Otorhinolaryngology Journal, 2008, 2, 7-12 7 Pathologic Features of on-invasive Fungal Rhinosinusitis Sarah E. Mowry 1, Sunita Bhuta 2 and Marilene B. Wang *,1,3 1 Division of Head and eck Surgery,
More informationSubcutaneous Fungi 10/13/2009. General Characteristics. Pathogenesis. Epidemiology. Laboratory Diagnosis. Specimens. Growth rate: 1-4 weeks
General Characteristics Growth rate: 1-4 weeks Subcutaneous Fungi Clinical Laboratory Science Program Carol Larson MSEd, MT(ASCP) Dematiaceous septate hyphae Hyaline septate hyphae Branching GPR Epidemiology
More informationPresentation of Invasive Fungal Rhinosinusitis in Sudanese Children: A Report of Four Cases
Volume 13, Issue no. 2, DOI 10.18502/sjms.v13i2.2643 Production and Hosting by Knowledge E Case Report Presentation of Invasive Fungal Rhinosinusitis in Sudanese Children: A Report of Four Cases Faculty
More informationActinomycosis and aspergillosis in the nose of a diabetic: A case report
Volume 2 Issue 3 2012 ISSN 2250-0359 Actinomycosis and aspergillosis in the nose of a diabetic: A case report 1 Meenu Khurana Cherian 1*, Rajarajeswari 2 1 Department of ENT, Gulf Medical College Hospital
More informationISSN: Volume 4 Issue CHOLESTEROL GRANULOMA: AN UNCOMMON CLINICAL ENTITY OF THE MAXILLARY SINUS
ISSN: 2250-0359 Volume 4 Issue 4 2014 CHOLESTEROL GRANULOMA: AN UNCOMMON CLINICAL ENTITY OF THE MAXILLARY SINUS Sunita Singh Sonia Chhabra Pansi Gupta Priya Malik Pt B.D. Sharma PGIMS, Rohtak, Haryana
More informationThe Differentiation of Yeast and Yeast-Like Forms in Human Tissues. Introduction. Histochemical Stains Used to Detect Fungi. Histopathologic Diagnoses
The Differentiation of Yeast and Yeast-Like Forms in Human Tissues Gary W. Procop, MD Chair, Clinical Pathology Staff, Anatomic Pathology Director, Molecular Microbiology, Mycology, and Parasitology Cleveland
More informationMedical Mycology Case Reports
Medical Mycology Case Reports 1 (2012) 107 111 Contents lists available at SciVerse ScienceDirect Medical Mycology Case Reports journal homepage: www.elsevier.com/locate/mmcr Granulomatous invasive fungal
More informationAllergic fungal rhinosinusitis: an overview on pathogenesis, early diagnosis and management
International Journal of Otorhinolaryngology and Head and Neck Surgery Suri N et al. Int J Otorhinolaryngol Head Neck Surg. 2018 May;4(3):694-700 http://www.ijorl.com pissn 2454-5929 eissn 2454-5937 Original
More informationSubcutaneous Mycosis
Subcutaneous Mycosis Fungal infections 1. Superficial mycosis. 2. Coetaneous mycosis: Dermatophytoses. 3. Subcutaneous mycosis. 4. Systemic mycosis. 5. Opportunistic mycosis. Subcutanus mycoses Fungal
More informationJ of Evolution of Med and Dent Sci/ eissn , pissn / Vol. 4/ Issue 81/ Oct 08, 2015 Page 14240
INCREASED INCIDENCE OF FUNGAL SINUSITIS IN COASTAL REGION: A CASE SERIES I. Arumugam 1, Jalagandeesh B 2, Ganesh Bala 3, Ishani Borah 4, Sandeep Jith 5 HOW TO CITE THIS ARTICLE: I. Arumugam, Jalagandeesh
More informationRhinosinusitis: A Prospective Study
االله الرحمن الرحيم بسم Pathological l & Radiological i l Evidences in the Pathogenesis es s of Chronic Rhinosinusitis: A Prospective Study Prof. Dr. H. ABDEL FATAH, MD A. Prof. Dr. K. NOWEAM, MD Dr. Z.
More informationNasal Polyposis. DEPARTMENT OF ENT K.S.Hegde Medical Academy Deralakatte, Mangalore
Nasal Polyposis DEPARTMENT OF ENT K.S.Hegde Medical Academy Deralakatte, Mangalore Def: INTRODUCTION Chronic inflammatory disease of the mucous membrane in the nose & PNS, presenting as pedunculated smooth
More informationChronic Sinusitis. Acute Sinusitis. Sinusitis. Anatomy of the Paranasal Sinuses. Sinusitis. Medical Topics - Sinusitis
1 Acute Chronic is the inflammation of the inner lining of the parnasal sinuses due to infection or non-infectious causes such as allergies or environmental pullutants. If the inflammation lasts more than
More informationDiagnosis of Invasive Septate Mold Infections A Correlation of Microbiological Culture and Histologic or Cytologic Examination
Microbiology and Infectious Disease / DIAGNOSIS OF SEPTATE MOLD INFECTIONS Diagnosis of Invasive Septate Mold Infections A Correlation of Microbiological Culture and Histologic or Cytologic Examination
More informationMucor Mycosis maxilla with palatal destruction An Interesting Case Report with Literature Review
ISSN 2250-0359 Volume 3 Issue 3.5 2013 Mucor Mycosis maxilla with palatal destruction An Interesting Case Report with Literature Review 1 Balasubramanian Thiagarajan 2 Venkatesan Ulaganathan 1 Stanley
More informationPRESENTATION AND MANAGEMENT OF ALLERGIC FUNGAL SINUSITIS
ORIGINAL ARTICLE PRESENTATION AND MANAGEMENT OF ALLERGIC FUNGAL SINUSITIS Kalimullah Thahim, Mahboob Afzal Jawaid and M. Saleem Marfani ABSTRACT Objective: To assess the presentation of allergic fungal
More informationOrbital cellulitis. Archives of Emergency Medicine, 1992, 9,
Archives of Emergency Medicine, 1992, 9, 143-148 Orbital cellulitis D. P. MARTIN-HIRSCH, S. HABASHI, A. H. HINTON & B. KOTECHA University Department of ENT Surgery, Manchester Royal Infirmary, Manchester
More informationConventional Sinus Surgery Vs Fess
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 16, Issue 7 Ver. III (July. 2017), PP 44-51 www.iosrjournals.org Conventional Sinus Surgery Vs Fess *
More informationENT Infections. Case 1. Diagnosis. Marlene L. Durand, M.D. Mass. General Hospital Mass. Eye & Ear Infirmary
ENT Infections Marlene L. Durand, M.D. Mass. General Hospital Mass. Eye & Ear Infirmary Case 1 18 yr-old patient presents with L eyelid swelling, redness, and pain. He was well until 10 days ago, when
More informationOrbital cellulitis. Archives of Emergency Medicine, 1992, 9,
Archives of Emergency Medicine, 1992, 9, 143-148 Orbital cellulitis D. P. MARTIN-HIRSCH, S. HABASHI, A. H. HINTON & B. KOTECHA University Department of ENT Surgery, Manchester Royal Infirmary, Manchester
More information1. BRIEF DESCRIPTION OF TRAINING
RHINOLOGY 1. BRIEF DESCRIPTION OF TRAINING Exposure to clinical rhinology is provided in each of the four ORL years over the course of several rotations in a graduated approach. MEE General Otolaryngology
More informationNational Imaging Associates, Inc. Clinical guidelines/considerations SINUS & MAXILLOFACIAL AREA CT 70486, 70487, 70488
National Imaging Associates, Inc. Clinical guidelines/considerations SINUS & MAXILLOFACIAL AREA CT 70486, 70487, 70488 Date: September 1997 Page 1 of 5 LIMITED OR LOCALIZED FOLLOW UP - SINUS CT 76380 Guideline
More informationDefinition. Phaeohyphomycosis
Phaeohyphomycosis Synonyms: Cerebral chromomycosis, chromoblastomycosis, chromomycosis, cladosporiosis, phaeomycotic cyst, phaeosporotrichosis, subcutaneous mycotic cyst. Definition Phaeohyphomycosis consists
More informationDiagnostic Accuracy in Sinus Fungus Balls: CT Scan and Operative Findings
tg.jar 200? _A:\ : Di3LiS/;-JESS Diagnostic Accuracy in Sinus Fungus Balls: CT Scan and Operative Findings Hun-Jong Dhong, M.D., Jae-Yun Jung, M.D., and Joo Hyun Park, M.D. ABSTRACT A fungus ball may be
More informationPott s Puffy Tumor. Shahad Almohanna 15/1/2018
Pott s Puffy Tumor Shahad Almohanna R2 15/1/2018 Definition First described in 1760 by Sir Percival Pott. s he originally suggested that trauma of the frontal bone was causative for this lesion, but later,
More informationMucocele of paranasal sinuses
From the SelectedWorks of Balasubramanian Thiagarajan March 7, 2012 Mucocele of paranasal sinuses Balasubramanian Thiagarajan Available at: https://works.bepress.com/drtbalu/57/ Mucoceles of paranasal
More information2046: Fungal Infection Pre-Infusion Data
2046: Fungal Infection Pre-Infusion Data Fungal infections are significant opportunistic infections affecting transplant patients. Because these infections are quite serious, it is important to collect
More informationResearch Article Allergic Fungal Rhinosinusitis: A Study in a Tertiary Care Hospital in India
Allergy Volume 2016, Article ID 7698173, 6 pages http://dx.doi.org/10.1155/2016/7698173 Research Article Allergic Fungal Rhinosinusitis: A Study in a Tertiary Care Hospital in India Ravinder Kaur, 1,2
More informationFunctional Endoscopic Sinus Surgery (FESS)
Functional Endoscopic Sinus Surgery (FESS) Last Review Date: December 12, 2017 Number: MG.MM.SU.56C2 Medical Guideline Disclaimer Property of EmblemHealth. All rights reserved. The treating physician or
More informationCongestion, headache, recurrent infection, post-nasal drip, smell problems? We can find the source and offer solutions for relief.
Sinus Sinus Congestion, headache, recurrent infection, post-nasal drip, smell problems? We can find the source and offer solutions for relief. So what is sinusitis? Although many individuals interpret
More informationAllergic Fungal Rhinosinusitis
10.5005/jp-journals-10013-1124 Ashok K Gupta et al ARTICLE 3 Ashok K Gupta, Nishit Shah, Mohan Kameswaran, Davinder Rai, TN Janakiram, Hemant Chopra, Ravi Nayar Arvind Soni, NK Mohindroo, C Madhu Sudana
More informationHistopathology of Nasal Masses
ORIGINAL ARTICLE Histopathology of Nasal Masses 1 Hemant Chopra, 2 Kapil Dua, 3 Neha Chopra, 4 Vikrant Mittal AIJCR Histopathology of Nasal Masses 1 Professor and Head, Dayanand Medical College, Ludhiana,
More informationAspergillosis in Dogs A Destructive Sinus & Nasal Disease
Aspergillosis in Dogs A Destructive Sinus & Nasal Disease No one likes having a runny nose. Primary viral and secondary bacterial infections are common in pets and people. Most of the time these infections
More informationAllergic Fungal Rhinosinusitis in Patients with Nasal Polyposis
Iraqi JMS Published by Al-Nahrain College of Medicine P-ISSN 1681-6579 E-ISSN 2224-4719 Email: iraqijms@colmed-alnahrain.edu.iq http://www.colmed-alnahrain.edu.iq http://www.iraqijms.net Allergic Fungal
More informationConcepts in Rhinosinusitis. Nick Jones University of Nottingham
Concepts in Rhinosinusitis Nick Jones University of Nottingham Definition of rhinosinusitis Very broad and is based on clinical symptoms, CT and endoscopy NOT on pathology Definition of rhinosinusitis
More informationInvasive Aspergillosis Associated Bacterial Infection in the Nasal Septum After Sphenoid Sinus Surgery
Case Report Korean J Otorhinolaryngol-Head Neck Surg 2018;61(10):541-5 / pissn 2092-5859 / eissn 2092-6529 https://doi.org/10.3342/kjorl-hns.2017.17657 Invasive Aspergillosis Associated Bacterial Infection
More informationECMM Excellence Centers Quality Audit
ECMM Excellence Centers Quality Audit Person in charge: Department: Head of Department: Laboratory is accredited according to ISO 15189 (Medical Laboratories Requirements for quality and competence) Inspected
More informationInverted papilloma of the nasal cavity and paranasal sinuses: a study of 20 cases
Original article: Inverted papilloma of the nasal cavity and paranasal sinuses: a study of 20 cases 1 Dr. Vijay Kumar Kalra, 2 Dr. Samar Pal Singh Yadav, 3 Dr. Swati 1Assistant Professor, 2 Senior Professor
More informationIsolated sphenoid inflammatory diseases
International Journal of Otorhinolaryngology and Head and Neck Surgery http://www.ijorl.com pissn 2454-5929 eissn 2454-5937 Original Research Article DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20183688
More informationSINUS SURGERY. Dr Zenia Chow MBBS(hons), FRACS
SINUS SURGERY Dr Zenia Chow MBBS(hons), FRACS Facial Plastic & Reconstructive Surgeon Otolaryngology, Head and Neck Surgeon ENDOSCOPIC SINUS SURGERY/FESS What are sinuses The sinuses are a connected system
More informationDestructive Giant Maxillary Sinus Mucocele: A Case Report
Destructive Giant Maxillary Sinus Mucocele: A Vahit Mutlu 1, Ozgur Yoruk 1, Ozalkan Ozkan 2 1 Atatürk University Faculty of Medicine, Department of Ears, Nose and Throat, Erzurum, Turkey 2 Erzincan University
More informationFRONTAL SINUPLASTY P R E P A R E D A N D P R E S E N T E D B Y : D R. Y A H Y A F A G E E H R 4 16/ 12/ 2013
FRONTAL SINUPLASTY P R E P A R E D A N D P R E S E N T E D B Y : D R. Y A H Y A F A G E E H R 4 16/ 12/ 2013 ANATOMY: FRONTAL SINUS Not present at birth Starts developing at 4 years Radiographically visualized
More informationComplications of Allergic Fungal Sinusitis
CLINICAL RESEARCH STUDY Complications of Allergic Fungal Sinusitis Sarah Bozeman, DO, a,b Richard deshazo, MD, a,b Scott Stringer, MD, c Leigh Wright, BA a a Department of Medicine and b Department of
More informationThe prevalence of positive fungal cultures in patients with chronic rhinosinusitis in a high altitude region of Iran
Iranian Journal of Otorhinolaryngology No.1, Vol.24, Serial No.66, Winter-2012 Original Article The prevalence of positive fungal cultures in patients with chronic rhinosinusitis in a high altitude region
More informationDr.Adel A. Al Ibraheem
Rhinology Chair Weekly Activity Dr.Adel A. Al Ibraheem www.rhinologychair.org conference@rhinologychair.org Rhinology Chair Introduction: It is important to classify and stage nasal polyposis. ( decide
More informationAllergic fungal rhinosinusitis: detection of fungal DNA in sinus aspirate using polymerase chain reaction
1- Allergic fungal rhinosinusitis: detection of fungal DNA in sinus aspirate using polymerase chain reaction Abstract Objective: This study investigated allergic fungal rhinosinusitis cases, and aimed
More informationAspergillus tamarii - a Rare Cause of Nasal Polyposis
ISSN: 2319-7706 Volume 4 Number 3 (2015) pp. 588-592 http://www.ijcmas.com Case Study Aspergillus tamarii - a Rare Cause of Nasal Polyposis Rahul Kamble* Department of Microbiology, TNMC & BYL Nair Ch.
More informationORIGINAL ARTICLE. Computed Tomographic Findings in Patients With Invasive Fungal Sinusitis
ORIGINAL ARTICLE Computed Tomographic Findings in Patients With Invasive Fungal Sinusitis John M. DelGaudio, MD; Ron E. Swain Jr, MD; Todd T. Kingdom, MD; Susan Muller, DMD; Patricia A. Hudgins, MD Objective:
More informationCase Report IgG4-Related Nasal Pseudotumor
Case Reports in Otolaryngology Volume 2015, Article ID 749890, 4 pages http://dx.doi.org/10.1155/2015/749890 Case Report IgG4-Related Nasal Pseudotumor L. K. Døsen, 1 P. Jebsen, 2 B. Dingsør, 3 and R.
More informationFOR CMS (MEDICARE) MEMBERS ONLY NATIONAL COVERAGE DETERMINATION (NCD) FOR COMPUTED TOMOGRAPHY:
National Imaging Associates, Inc. Clinical guidelines SINUS & MAXILLOFACIAL AREA CT LIMITED OR LOCALIZED FOLLOW UP SINUS CT Original Date: September 1997 Page 1 of 5 CPT Codes: 70486, 70487, 70488, 76380
More informationThe Ghost in the Closet. Allergic Sino-Bronchopulmonary Aspergillosis Without Bronchial Asthma: A Case Report & Review of the Subject
Proceeding S.Z.P.G.M.I. Vol: 24(1): pp. 55-59 2010. The Ghost in the Closet. Allergic Sino-Bronchopulmonary Aspergillosis Without Bronchial Asthma: A Case Report & Review of the Subject Department of Pulmonology,
More informationPrevalence of Fungal Allergy in Patients with Allergic Rhinosinusitis
Prevalence of Fungal Allergy in Patients with Allergic Rhinosinusitis Kyle Kennedy, M.D. Karen Calhoun,, M.D. June 5, 1999 Hypothesis Subset of patients with signs and symptoms of allergic rhinosinusitis
More informationInvasive Fungal Rhinosinusitis: A 15-Year Experience With 29 Patients
The Laryngoscope VC 2013 The American Laryngological, Rhinological and Otological Society, Inc. Invasive Fungal Rhinosinusitis: A 15-Year Experience With 29 Patients Marcus M. Monroe, MD; Max McLean, BA;
More informationChronic Rhinosinusitis-Treatment
Chronic Rhinosinusitis-Treatment INFECTION INFLAMMATION Predisposing Factors Anatomical variations Allergic rhinitis Acute sinusitis Immune deficiency Rhinosinusitis Non-allergic rhinitis Chronic sinusitis
More informationORIGINAL ARTICLE. Computed Tomographic Staging and the Fate of the Dependent Sinuses in Revision Endoscopic Sinus Surgery
Computed Tomographic Staging and the Fate of the Dependent es in Revision Endoscopic Surgery Neil Bhattacharyya, MD ORIGINAL ARTICLE Objectives: To determine the patterns of disease recurrence in chronic
More informationChapter Five. 1 of 8 11/3/2008 2:52 PM.
1 of 8 11/3/2008 2:52 PM Email : myousefmian@hotmail.com Chapter Five FRONT COVER Introduction Acknowledgement CHAPTERS Chapter One Chapter Two Chapter Three Chapter Four Chapter Five Chapter Six Chapter
More informationAllergic fungal rhinosinusitis is observed to be. Evaluation of Diagnostic Criteria for AFRS: A Hospital Based Study. Main Article
Main Article Evaluation of Diagnostic Criteria for AFRS: A Hospital Based Study Krishna V Chaitanya, 1 Lakshmi C Kalavathi 2 ABSTRACT Introduction Bent and Kuhn criteria are the most commonly accepted
More informationCutaneous phaeohyphomycosis in an immunocompromised host
Hong Kong J. Dermatol. Venereol. (2014) 22, 85-89 Case Report Cutaneous phaeohyphomycosis in an immunocompromised host YXE Tay, JY Pan, SSJ Lee Phaeohyphomycosis is an infection caused by dematiaceous
More informationSinusitis: Medical and Surgical Management. R. Jonathan Lara, DO, FAOCO. Sonoran Ear Nose & Throat
Sinusitis: Medical and Surgical Management R. Jonathan Lara, DO, FAOCO Sonoran Ear Nose & Throat 27 th Annual Southwestern Conference on Medicine April 26, 2018 What are sinuses? Air filled cavities of
More informationFungal Sinusitis: A Ten-Year Experience at King Abdulaziz University Hospital
JKAU: Med. Sci., Vol. 20 No. 3, pp: 29-41 (2013 A.D. / 1434 A.H.) DOI: 10.4197/Med. 20-3.3 Fungal Sinusitis: A Ten-Year Experience at King Abdulaziz University Hospital Khalid B. Al-Ghamdi, MD, Almoaidbellah
More informationA CONTRIBUTION TO THE ETIOPATHOGENESIS, DIAGNOSIS AND MANAGEMENT OF SINONASAL INVERTED PAPILLOMAS
UNIVERSITY OF MEDICINE AND PHARMACY OF TÂRGU MUREȘ ROMANIA A CONTRIBUTION TO THE ETIOPATHOGENESIS, DIAGNOSIS AND MANAGEMENT OF SINONASAL INVERTED PAPILLOMAS PhD THESIS ABSTRACT PhD Student Viorel Emanoil
More informationA Prospective Clinical Study on Types and Diagnostic Criteria of Fungal Rhinosinusitis used in Tertiary Teaching Hospital of Telangana
Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2018/247 A Prospective Clinical Study on Types and Diagnostic Criteria of Fungal Rhinosinusitis used in Tertiary Teaching
More informationNasal mucosal melanosis may act as a harbinger of melanoma: A case report
Nasal mucosal melanosis may act as a harbinger of melanoma: A case report The Harvard community has made this article openly available. Please share how this access benefits you. Your story matters. Citation
More informationSphenoid rhinosinusitis associated with abducens nerve palsy Case report
Romanian Journal of Rhinology, Volume 8, No. 30, April-June 2018 CASE REPORT Sphenoid rhinosinusitis associated with abducens nerve palsy Case report Lucian Lapusneanu 1, Marlena Radulescu 1, Florin Ghita
More informationSyndromes of invasive fungal sinusitis
Medical Mycology 2009, 47 (Supplement 1), S309S314 Syndromes of invasive fungal sinusitis RICHARD D. DESHAZO University of Mississippi Medical Center, Department of Medicine, Jackson, Mississippi, USA
More informationMANAGEMENT OF RHINOSINUSITIS IN ADULTS IN PRIMARY CARE
PROFESSOR DR SALINA HUSAIN DEPUTY HEAD DEPARTMENT OF OTORHINOLARYNGOLOGY-HEAD NECK SURGERY UKM MEDICAL CENTRE MANAGEMENT OF RHINOSINUSITIS IN ADULTS IN PRIMARY CARE CLINICAL PRACTICE GUIDELINES ON MANAGEMENT
More informationPathophysiology and Etiology
Sinusitis Pathophysiology and Etiology Sinusitis is inflammation of the mucosa of one or more sinuses. It can be either acute chronic. Chronic sinusitis is diagnosed if symptoms are present for more than
More informationDIFFICULT-TO-TREAT CHRONIC
MANAGEMENT STRATEGIES FOR DIFFICULT-TO-TREAT CHRONIC RHINOSINUSITIS DR ZULKEFLI HUSSEIN CONSULTANT EAR NOSE & THROAT SURGEON PANTAI HOSPITAL PENANG DISCLAIMER Nothing to disclose PENANG ISLAND, MALAYSIA
More informationSinusitis: Medical and Surgical Management. R. Jonathan Lara, DO, FAOCO. Sonoran Ear Nose & Throat
Sinusitis: Medical and Surgical Management R. Jonathan Lara, DO, FAOCO Sonoran Ear Nose & Throat 27 th Annual Southwestern Conference on Medicine April 26, 2018 What are sinuses? Air filled cavities of
More informationAllergic Fungal Rhinosinusitis
Allergic Fungal Rhinosinusitis My Published Experience 1999-2018 Prof. Surayie H Al Dousary Professor of Rhinology Rhinology research Chair Director KSU Rhinology fellowship Program Director KSU Rhinology
More informationClinical Study of Fungal Granulomatous Diseases
International Journal of Advances in Health Sciences (IJHS) ISSN 2349-7033 Vol2, Issue5, 2015, pp665-669 http://www.ijhsonline.com Review Article Clinical Study of Fungal Granulomatous Diseases Sunil Pai
More informationEndoscopic Management Of A Giant Ethmoid Mucocele
ISPUB.COM The Internet Journal of Otorhinolaryngology Volume 6 Number 1 S Ceylan, F Bora Citation S Ceylan, F Bora.. The Internet Journal of Otorhinolaryngology. 2006 Volume 6 Number 1. Abstract We present
More informationFunctional Endoscopic Sinus Surgery
WHAT IS FUNCTIONAL ENDOSCOPIC SINUS SURGERY (FESS)? The nasal telescope has greatly changes the evaluation and treatment of rhino-sinusitis. This instrument, which provides a view of the structures in
More informationAllergic fungal sinusitis caused by Bipolaris (Drechslera) hawaiiensis
Eur Arch Otorhinolaryngol (1999) 256 : 330 334 Springer-Verlag 1999 RHINOLOGY A. Fryen P. Mayser H. Glanz R. Füssle H. Breithaupt G. S. de Hoog Allergic fungal sinusitis caused by Bipolaris (Drechslera)
More informationTransient pulmonary infiltrations in cystic fibrosis due to allergic aspergillosis
Thorax (1965), 20, 385 Transient pulmonary infiltrations in cystic fibrosis due to allergic aspergillosis MARGARET MEARNS, WINIFRED YOUNG, AND JOHN BATTEN From the Queen Elizabeth Hospital, Hackney, and
More informationHistopathology Description:
2013-2-1 CANINE HEART Ahmed M. Abubakar BOVINE PATHOLOGY CONTRIBUTING INSTITUTION : The Royal Veterinary college, Dept. of Pathology and Biology Signalment: 11-month-old male Border Collie dog (Canis familiaris)
More informationDose-dependent effects of tobramycin in an animal model of Pseudomonas sinusitis Am J Rhino Jul-Aug; 21(4):423-7
AMINOGLYCOSIDES Dose-dependent effects of tobramycin in an animal model of Pseudomonas sinusitis Am J Rhino. 2007 Jul-Aug; 21(4):423-7 http://www.ncbi.nlm.nih.gov/pubmed/17882910 Evaluation of the in-vivo
More informationRetrospective Analysis of Patients with Allergy Sinusitis
Original article: Retrospective Analysis of Patients with Allergy Sinusitis G.S. Thalor Senior Specialist (MS) (department of Oto Rhino Laryngology), Govt. S.K. Hospital, Sikar, Rajasthan, India. Corresponding
More informationNasal Polyps. Multimedia Health Education. Disclaimer
Disclaimer This movie is an educational resource only and should not be used to manage your health. All decisions about the management of Nasal Polyps must be made in conjunction with your Physician or
More informationExtranodal Natural Killer/T-Cell Lymphoma Nasal Type: Detection by Computed Tomography Features
The Laryngoscope VC 2014 The American Laryngological, Rhinological and Otological Society, Inc. Extranodal Natural Killer/T-Cell Lymphoma Nasal Type: Detection by Computed Tomography Features Yin-Ping
More informationAdvances in the Surgical Management of Chronic Rhinosinusitis
Rhinitis and Sinusitis dvances in the Surgical Management of Chronic Rhinosinusitis Erin D. Wright, MDCM, MEd, FRCSC; Saul Frenkiel, MDCM, FRCSC bstract The surgical management of chronic rhinosinusitis
More informationThe Nose and Sinuses. Ophir Ilan, MD, PhD Department of Otolaryngology/Head&Neck surgery Hadassah University Hospital
The Nose and Sinuses Ophir Ilan, MD, PhD Department of Otolaryngology/Head&Neck surgery Hadassah University Hospital Nasal Mucociliary System Function of the Nasal Mucosa warming and humidifying the
More informationIntroduction. Ophthalmic manifestations can result from a myriad of Non Sinogenic and Sinogenic Disease :
Ophthalmic Manifestations of Paranasal Sinus Disease; A Clinical Grading System Surayie Al Dousary, MD Associate Professor Director Rhinology Research Chair & Fatma Al Anazy, MD Associate Professor Rhinology
More informationDiagnosis and Management of Fungal Allergy Monday, 9-139
Diagnosis and Management of Fungal Allergy Monday, 9-139 13-2010 Alan P. Knutsen,, MD Director, Pediatric Allergy & Immunology Director, Jeffrey Modell Diagnostic Center for Primary Immunodeficiencies
More informationMANAGEMENT OF RHINOSINUSITIS IN ADOLESCENTS AND ADULTS
MANAGEMENT OF RHINOSINUSITIS IN ADOLESCENTS AND ADULTS Ministry of Health Malaysia Malaysian Society of Otorhinolaryngologist - Head & Neck Surgeons (MS)-HNS) Academy of Medicine Malaysia KEY MESSAGES
More informationISSN X (Print) Research Article. *Corresponding author Dr.V. Krishna Chaitanya
Scholars Journal of Applied Medical Sciences (SJAMS) Sch. J. App. Med. Sci., 2015; 3(1G):508-513 Scholars Academic and Scientific Publisher (An International Publisher for Academic and Scientific Resources)
More informationwww.oralradiologists.com CONE BEAM CT REPORT CASE ---- Case Information Referring Doctor: - Patient Name: - Scan Date: December 1, 2015 Patient DOB: - Reason for Exam: - Study Details: icat Flex, 160x160x112
More information