A patient presented to ENT OPD with complaints of headache and nasal stuffiness. On CT scan Heterogeneous opacification involving multiple sinuses along with Bone erosion (as shown below) was noticed. What would be the most likely diagnosis?
Heterogeneous opacification in multiple sinuses with areas of central hypoattenuation is characteristic of AFRS. Erosion of medial wall of right orbit can be clearly seen without any invasion into the orbit as Medial Rectus Muscle can be clearly seen with out distoion. ( compare with Left Side) Areas of increased signal intensity are thought to be due to the accumulation of heavy metals such as iron, manganese, and calcium within the inspissated allergic mucin.
Acute bacterial rhinosinusitis
Chronic Bacterial rhinosinusitis
Allergic Fungal rhinosinusitis
Invasive Fungal Rhinosinusitis
Diseases of Nose and Paranasal Sinuses