Sphenoid Nasalization in Allergic Fungal Sphenoidal Sinusitis
Keywords
Abstract
Description
Fungal rhinosinusitis classified into invasive and noninvasive subtypes. Phenotypes of noninvasive fungal rhinosinusitis occur in immunocompetent subjects and include: local fungal colonization, fungal ball, and allergic fungal rhinosinusitis. Subtypes of invasive fungal rhinosinusitis include acute invasive fungal rhinosinusitis, chronic invasive fungal rhinosinusitis and granulomatous invasive rhinosinusitis.
The estimated incidence of sphenoid sinusitis is only 2.7% of all nasal sinus infections, also the diagnosis of sphenoid sinus fungal infection is sometimes difficult. Clinical signs are often non specific and nasal endoscopy can be strictly normal.Early diagnosis is therefore difficult and diagnosis is often delayed with headache that may sometimes persists for several years before diagnosis of the disease.
In most cases of sphenoid sinusitis, enlargement of the obstructed sinus ostium is sufficient to provide drainage of retained secretions and reestablish mucociliary clearance.According to Simmen and Jones, a type I sphenoidotomy entails identification of the ostium without further intervention; a type II sphenoidotomy entails enlargement of the ostium upward to the level of the cranial base, and inferiorly to one-half of the sinus height; and a type III sphenoidotomy involves widening the ostium to its most lateral extent.
Eloy et al in 2017 stuited that,In more extensive sphenoid sinus surgery is reserved for cases where in the disease process is extensive or previous surgery has failed. In some cases sphenoid nasalization in which bilateral extended sphenoidotomy is necessary. In this procedure, the posterior aspect of the nasal septum is resected, along with the sphenoid rostrum, the intersinus septum, and other intrasphenoid partitions, creating a common cavity with a broad drainage pathway . It also allows access to the lateral recesses of this sinus.
Dates
Last Verified: | 02/28/2019 |
First Submitted: | 03/16/2019 |
Estimated Enrollment Submitted: | 03/16/2019 |
First Posted: | 03/18/2019 |
Last Update Submitted: | 03/16/2019 |
Last Update Posted: | 03/18/2019 |
Actual Study Start Date: | 03/31/2019 |
Estimated Primary Completion Date: | 03/31/2022 |
Estimated Study Completion Date: | 09/30/2022 |
Condition or disease
Intervention/treatment
Procedure: sphenoidotomy versus sphenoid nasalisation
Phase
Arm Groups
Arm | Intervention/treatment |
---|---|
Active Comparator: sphenoidotomy (group A) sphenoidotomy opening of sphenoid sinus ostum and cleaning of the sinus | |
Active Comparator: sphenoid nasalization (group B) sphenoid nasalization in which bilateral extended sphenoidotomy, the posterior aspect of the nasal septum is resected, along with the sphenoid rostrum, the intersinus septum, and other intrasphenoid partitions, creating a common cavity with a broad drainage pathway . |
Eligibility Criteria
Sexes Eligible for Study | All |
Accepts Healthy Volunteers | Yes |
Criteria | Inclusion Criteria: - Any age. - Any case of allergic fungal sinusitis unilateral or bilateral involving the sphenoid sinus Exclusion Criteria: - Acute invasive fungal sinusitis. - Previous Sinonasal surgery. - Unfit patient for surgery. |
Outcome
Primary Outcome Measures
1. rate of recurrence [6 month]
Secondary Outcome Measures
1. Type of caustive organism [2weeks]