M B Gillespie1, D M Huchton, B W O'Malley. 1. Department of Otolaryngology--Head and Neck Surgery, Medical University of South Carolina, Charleston 29425, USA.
Abstract
OBJECTIVE: To determine the efficacy of middle turbinate biopsy in the diagnosis of fulminant invasive fungal rhinosinusitis. STUDY DESIGN: Nonrandomized prospective study. METHODS: Directed middle turbinate biopsy was performed in 25 patients suspected of having fulminant invasive fungal rhinosinusitis. All patients were immunocompromised and had fever of unknown origin, symptoms of rhinosinusitis, or both. RESULTS: Six patients were found to have fungal invasion on histopathological review (6 true-positive findings), disease developed in 2 patients with negative results on biopsy (2 false-negative findings), and disease never developed in 17 patients with negative results on biopsy (17 true-negative findings), resulting in an overall sensitivity of 75% and a specificity of 100%. CONCLUSIONS: Middle turbinate biopsy is a safe and effective method of making a timely diagnosis of fulminant invasive fungal rhinosinusitis. The added morbidity and cost of surgery can be avoided in the patient with a negative finding on biopsy. However, the effect of earlier diagnosis on overall patient survival is unclear at present.
OBJECTIVE: To determine the efficacy of middle turbinate biopsy in the diagnosis of fulminant invasive fungal rhinosinusitis. STUDY DESIGN: Nonrandomized prospective study. METHODS: Directed middle turbinate biopsy was performed in 25 patients suspected of having fulminant invasive fungal rhinosinusitis. All patients were immunocompromised and had fever of unknown origin, symptoms of rhinosinusitis, or both. RESULTS: Six patients were found to have fungal invasion on histopathological review (6 true-positive findings), disease developed in 2 patients with negative results on biopsy (2 false-negative findings), and disease never developed in 17 patients with negative results on biopsy (17 true-negative findings), resulting in an overall sensitivity of 75% and a specificity of 100%. CONCLUSIONS: Middle turbinate biopsy is a safe and effective method of making a timely diagnosis of fulminant invasive fungal rhinosinusitis. The added morbidity and cost of surgery can be avoided in the patient with a negative finding on biopsy. However, the effect of earlier diagnosis on overall patient survival is unclear at present.