Bone Regeneration in Allergic Fungal Rhinosinusitis: Post-treatment Image Follow Up

Background: Bone erosion is a feature of allergic fungal rhinosinusitis (AFRS). The incidence of bone regeneration after treatment is unknown. The objective of this study is to evaluate the fate of bone erosion in AFRS. Materials and methods: A retrospective chart review was conducted for all AFRS patients who had preoperative evidence of bone erosion on the computed tomography (CT) of the paranasal sinus (PNS) and at least one postoperative image. We used the bone erosion score (BES) as a valid tool to evaluate the preoperative bone erosion extension and the rate of regeneration on postoperative images. Results: A total of 40 patients met our enrollment criteria. Of these, 30 patients underwent CT within nine months postoperatively (mean baseline BES: 9.07, SD: 8.11), 33 patients underwent CT between nine and 18 months postoperatively (mean baseline BES: 9.36, SD: 8.80), and 34 patients underwent CT after 18 months postoperatively (mean baseline BES: 8.56, SD: 7.69). The BES improved by 88.92% within nine months postoperatively with a follow-up BES of 0.93 (SD: 1.65), by 90.29% between nine and 18 months with a follow-up BES of 0.91 (SD: 2.15), and by 96.57% after 18 months with a follow-up BES of 0.29 (SD: 0.62). Complete bone regeneration occurred in 27 patients (67.50%); this was noted within nine months in 21 patients and after 18 months in six. Among them, 16 were male and 11 were female (p = 0.75). Regarding their ages, eight were pediatric and 19 were adult patients (p = 0.31). Conclusion: Bone erosion in AFRS is a mostly reversible process. Complete bone regeneration occurred in more than two-thirds of patients within a short period of time.