Value of investigation in the diagnosis of allergic fungal rhinosinusitis:results of a prospective study

The authors report a prospective study in which the aim was to analyse the usefulness of different criteria in optimizing the diagnosis of allergic fu ngal rhinosinusitis. From 1995 to 1998, 165 patients were operated on for c hronic rhinosinusitis. Investigations used in this study for the diagnosis of allergic Aspergillus rhinosinusitis consisted of an analysis of clinical , radiological, pathological, mycological, and immune-allergic criteria. Fo urteen patients presented with allergic Aspergillus rhinosinusitis. One hun dred and fifty-one patients did not present an!: of the necessary criteria for the diagnosis of allergic Aspergillus rhinosinusitis. The results show that the characteristic macroscopic appearance, the maxillary sinus localiz ation, and the presence of positive specific IgE to Aspergillus fumigatus a re arguments that reinforce the diagnostic certitude of allergic fungal sin usitis. No specific clinical or radiological criteria orients a diagnosis o f chronic rhinosinusitis toward that of allergic fungal rhinosinusitis. The ether immuno-allergic tests do not contribute to the diagnosis of allergic fungal rhinosinusitis.