Philpott and Javer reported an endoscopic staging system for patients with allergic fungal rhinosinusitis. The authors are from the University of East Anglia in England and St. Paul's Sinus Center in Vancouver.
Patient selection: allergic fungal rhinosinusitis
Sites examined on left and right side:
(1) frontal sinus
(2) ethmoid sinus
(3) maxillary sinus
(4) sphenoid sinus
Parameters:
(1) mucosal edema
(2) polypoid edema
(3) polyps
(4) fungal mucin (thick and tenacious, tan-green-brown with eosinophils and/or fungal hyphae)
Finding
Points
no mucosal edema
0
mild mucosal edema
1
moderate mucosal edema
2
severe mucosal edema
3
mild polypoid edema
4
moderate polypoid edema
5
severe polypoid edema
6
polyps present, mild
7
polyps present, moderate
8
polyps present, severe
9
Fungal Mucin
Points
absent
0
present
1
subscore for each sinus =
= (points for mucosal appearance) + (points for fungal mucin)
score for each side =
= SUM(points for all 4 sinuses)
Interpretation:
• minimum subscore for a sinus: 0
• maximum subscore for a sinus: 10
• minimum score for the left or right side: 0
• maximum score for the left or right side: 40
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