You are on page 1of 50

m   

m
 


m  

  
! 
"#"$%""&
Fungal sinusitis
w  '
# ()* + +,  

 -
% 
) + +
. */
0 ( *  ,(*-
w  ',1  %""2((34-
w + +'
w (*+ +*  ,(**-
w 
+ +*  ,*-
w   + +*  ,*
w + +'
w  
* ,*-
w  * /,*/-
w  
 * 
w ( *  ,(*-
w  
*
   , * -
w   
÷ntroduction
#&5$ '

1       
   (   6   6

1  +
  

  
 
 6
 1 
 
3   ,(/(-
#&2# 
    1
    16  
   6
    
      6
(/(
#&2.78 
(    
 

 9   

 6 
     
   5 


     
 1 
 1 
 
   
w (    ,  

   :(* -   1 1 
#&2&  1   
;     

  
w (

(*     
 
     
 
    
 

   , -<
w =(*
1 


w  1  
  ++ 6  6 
 
6
  (* 8  

  
w '
w     
   
w 4
  6
 
 ((  +
w   #
w 3  '+>"?
w (*'
w (    
w @  1 
w *
 
w A  '+."?
w Frequency:
w   
 B>#"C 
1

    
  (*
w 
, )*- (*;
ërganism
*(* 6 

 , -
w 3  

w  
w  
w 3 
Úathogenesis

  (*
  +  ; 
  
  

 
   +,- 
49(  B   
B    
1   
  
he Natural History
w (*  1 
 
 
  
   
w  
  
   
  6

 

    +


w 
  
++ +
   6


  
w 

  +
+ +
   


  
 
 

w    1  

    
+ + +
w  
    
  6     
       :
 
   6

   
 6
 

+ 
w 3 e opposi e end of e spec rum from e
immunocompromised is e immunologically
Dzypercompe en  e a opic pa ien   is in
is os a 3FRS manifes s

w (*  6
+ 
B 

w   
+6

 B>5B#"D   +    
6
%0
  
w 
  6
  + 
    1 
 , 1-  

+  
w         
 B1
1  
   
w 
  
B++
E      
B 1  
w  1  
  B 1
 
    
Mymptoms of AFRM
w  
w 3 
w  
w   + 
w  
 

    
w 
 
     
+

       
w 
+  
w     
 6
(* 
w ++  6
 
  
+(*   1B 
  11     
   

  6




  1

ëcular Manifestations
w 2% 
w 3 1++6
+  6 
#0$C
  
 
w    , $#C -
w 
 , 5.C-
w !   (*  .5C
 6  + 16
  
 
   

  /* 11  6    1  9'(    


+  (F
 #&&& 
miagnosis
Bent and Kuhn miagnostic critreria
w *+E    '
w +
  +, 
-1
         
w    
w 
    
 
w  
 
w  + 
w B    
w  
,2)#>-
w   ,#.)#>-
w  
1  ,#%)#>-
w  ,##)#>-
w 
 9   ,$)#>-
w   
,$)#>-
 8 
     



B 0- + 1
1  B   + 
    
 6
  

6
  
   
)  +  1
 


   
 
 6



     
+(* 
w    8

  (*  
 1
  1 
   

   
+ 1  
 (* 
  +
 ; 1
w +   +   

  (*       

    
 6
  
 
 


   
 
  1 (* 
÷g E levels
w  +   +(*,&"C-
w  + 
 1  

+ 1 
 
  
w  + 
+1     
(*+
÷maging in AFRM
(*    
   
   
  6

  +
     
  #6

  +%6
  

      
   

 

  +  
           
 

   
+ , 
  -6
    


B     


++  6
6 ,&2C-6 
B   


w /   
B
  
 
 
 1 
     
 
   
 116  
    


   1
++
   1  m  
   

 
 
  (


B  
  1    
  1  +1

  ( 
(*  
+
    

++

      
Allergic (Eosinophillic) mucin
w 

 (*
w  
  1
 (*
w     
 
  


+  
w 1 
w (      

   :
        

  1
   (*
w    8
 
  
 

      
6 +

 
   
  (*
w B  1 ++
      +   6



   

1 1

+  
  
w 3   1
 

B  
m      
    
 B  


  B       


  31   + 734  ) 
            (*  6


 
 B  +  


 3  
     1 1 
   

      
6
          
       m  

 
    +  1     +  
 
   

     
  
    +      
  
Histology
w B
 6

B
   +  
 
 9
     1 

6

1  
 1 
 
 
w 

 9     
 
 
    8 %$"
  
w 
     66
/ 6
/  
w  
 +   8
+ 8
 6

 
w *   6
   
   

  

       
6

 

   
     +  
 1 
w *   8 
 ;1
1  1 + 
    
1   +   + 
  
  G   G  + 
, -  6

 1  1 6

   
 
4H   B  


REA MEN
w (+    (*
+  1

  +   6 8 
 #"C #""C   

  
     
 + 
w ( 
 +  
1
     
 
6 +     (* 
Murgery
w 
    +  
  6
   + 
 + 
   
w m 
 + + 
 
 
(*      

 
 

   
  

  16 B  
w 
     + 1  
 

÷mmunotherapy

   
  
,
   -   

 6  
 ,
B   
   
  -
Antifungals
w ('
w 
1     

  
w (
 / 8  8 
8
+1+
w B   
+1  :
   
B +   
w  +
 9*
Mteroids
w 

 '
w 
  
w ( I 
w 9
   
w 9>9#.
w (+ 

w  +

 6    +
w  
     

 ,



 
 + -
w  
  E 1  , /-
w B
,."""B-
w 

w    1    (/ 
w   '
w 
w 
1   + 
 
w 9 
 
w   
  
w   +     
    1

   
   
1
w     0","0)-  0
 
  
 1"#)) 0
  %")6  
, "%)) 
6

+    -
w (
#
  ++   E "%
)) 
   + 6 1
w 
 6  " 0 +

"%))  :
w 
    "#)) %

       6     ; 

 
  
w ( $
  " 
   
 
       

 
w       +5 #0 
0% 
6
6
 
B    +  1
    # 
w 
 6+ %
 (*  
6
    
w   6
 %
 
    6  6

 6

+    (#  
     6
     6 
 
+B   
(*,.>C-

 6

,>>C-

(    '   


*  (7
  m *(  6F   m
 33 H4  %"". ##'#J>
w 7 1 ( 
 6
      6

6   
 
       
 
w
w K"    
w K#  6)6
 
w K% 6)6
 
w K.   6
1  )
Endoscopic mucosal staging

"
Endoscopic mucosal staging


w 
     
    
w LB  
   '
w
w K  
w Km  
w K 
w
w 4   +     
  6
  
6   
       
 +  
 (/(
   
16
6   
w (#"
       6 
 6
  1  
 6 
  4

   6 6

      
  1
6 
   

  

   
6 6

     
  4
  6 
  +
hank You