Fungi as Causative agent of nasal polyps

Nasal polyposis is an inflammatory condition of unknown etiology that involves nasal and sinus mucous membrane. These polyps can impair a person's quality of life by nasal obstruction, recurrent sinusitis, persistent postnasal drainage, hyposmia, anosmia, changes in sense of taste and even bony destruction. It has been shown that chronic inflammation causes a reactive hyperplasia of the intranasal mucosal membrane which results in the formation of polyps. Recently, fungal elements were suspected to be the causative agent of chronic rhinosinusitis and a fungal etiology has been proposed to underlie severe nasal polyposis. The present study was undertaken to determine the role of fungi in development of nasal polyps. In this study resected polyps from 100 patients were examined by mycological and pathological methods for the presence of fungi. Fungal elements were shown in 9 samples by mycological methods and isolated fungi were Aspergillus flavus, Aspergillus fumigatus and Rhizopus sp. Tissue invasion by fungi also was seen by histopathological examination in 6 patients. Therefore, fungi could be considered as the causative factor in the development of nasal polyposis in those patients and since medical treatment of nasal polyps have become increasingly recognized in recent years, the present study also implying the benefits of topical antifungal therapy in such cases

Multiple mucoceles in cystic fibrosis and Role of endoscopic sinus surgery in its treatment

Cystic Fibrosis [CF] is a hereditary disorder of mucous glands which due to impairment of sodium and chloride secretion affects mucosal surfaces. Although sinonasal complaints are common in CF patients, it presents usually as sinusitis or nasal polyposis and mucocele formation is a rare presentation of CF. Here we present a six year-old boy presenting with telecanthus and progressive nasal deformity as a result of multiple mucoceles in ethmoid, maxillary and sphenoid sinuses. This article discuss about this patient and reviews the role of endoscopic sinus surgery in CF patients

Fungal Involvement in Patients with Paranasal Sinusitis

Fungal involvement of the paranasal sinuses is frequently observed in the immunocompromised host and it can become lifethreatening if it is not diagnosed. Definitive diagnosis is made by tissue biopsy and culture. In this study biopsy materials of maxillary, ethmoidal and frontal sinuses of 60 patients with clinical manifestation of sinusitis and no response to medical therapy were assessed by mycological and pathological methods for the presence of fungi. Invasive fungal sinusitis was diagnosed in 3 patients and etiologic agents were C and ida albicans, Rhizopus sp. and Aspergillus fumigatus. Predisposing factors in these patients were leukemia, diabetes mellitus and previous sinus and polyp surgery, respectively. Allergic fungal sinusitis also was seen in one patient and Alternaria sp. isolated from the biopsy material. Only the patient with allergic form of disease survived but all the patients with invasive form of fungal infection were expired. This clearly underscores the need of early recognition of fungal sinusitis in at risk population in order to start urgent treatment. In this study Nocardia asteroids also was isolated from the biopsy sample in a patient with sinunasal adenocarcinoma

Suppression of tinnitus in patients undergoing cochlear implantation

Tinnitus is a frequent complaint in patients with sensorineural deafness. Different reports suggest that electrical stimulation caused by cochlear implant devices supresses tinnitus to a considerable degree. In a longitudinal study we have evaluated the severity and duration of tinnitus in both ears of 17 cochlear implant patients before and after operation. Severity of tinnitus was reduced in both implanted and not implanted ears after the implantation [P = 0.003 and P = 0.004 respectively]. Duration of tinnitus, however, was not affected significantly. No significant difference in tinnitus suppression was observed between the implanted and not implanted ears. This might be attributed to both the electrical stimulation caused by the device and the psychogenic stability provided by return to the world of sound