Epidemiologic factors affect surgical outcomes in allergic fungal sinusitis

OBJECTIVES: To evaluate discrepancies in presentation and postoperative outcomes in a population of allergic fungal sinusitis (AFS) patients. STUDY DESIGN: Prospective cohort study. METHODS: Clinical and demographic records of 48 patients (26 males, 22 females) who underwent endoscopic sinus surgery (ESS) for treatment of AFS were collected from 2003 to 2008. All patients completed pre- and postoperative Sinonasal Outcome Test (SNOT)-20 questionnaires. Patients also underwent objective grading via the Lund-Kennedy nasal endoscopy and the Lund-Mackay computed tomography (CT) scan scoring systems. This data was interrogated by means of both univariate and multivariate analysis through the use of Mann-Whitney and chi-square tests to calculate statistical significance. RESULTS: Preoperatively African-Americans had significantly higher Lund-Mackay and mean endoscopy scores (P < .05) than Caucasians. However, there was no significant difference among SNOT-20 scores. Postoperative symptom and endoscopy scores improved in all patient groups with significantly greater improvement in women (both P < .05) versus men at 12 months. Improvement ratio of preoperative versus postoperative endoscopy scores trended toward significance at 6 months (P = .08), with African-Americans improving more than Caucasians. CONCLUSIONS: Epidemiologic factors may play an important role in the presentation and progression as well as in surgical outcomes of patients diagnosed with allergic fungal sinusitis.