Abstract
Introduction: In recent years, interest in the fungal pathology of the rhinosinus has been renewed, and numerous studies have been published on the possible responsibility of fungal agents in rhinosinus pathologies.
Objective: To study clinico radiological characteristics of fungal rhinosinusitis and discuss therapeutic modalities of this entity.
Methods: This is a retrospective descriptive study conducted at the ENT and cervicofacial surgery department, which enrolled patients treated for rhinosinusitis over a 20-year period.
Results: Our study included 45 patients treated for fungal rhinosinusitis. Fungal ball (22 cases) was the most frequent entity. Dental origin was found in 15 patients. Facial imaging (CT+/-MRI) was performed in all cases. Mycological examination was positive in 19 patients. Forty-one patients (91%) underwent exclusive endonasal surgery under endoscopic guidance. Pathological examination was suggestive of sinonasal aspergillosis in 20 cases. Nine patients were treated with antifungal agents. Local recurrence was noted in four patients after an average follow-up of 14 months.
Conclusions: Fungal rhinosinusitis is the leading cause of chronic unilateral sinusitis in adults. Despite improvements in diagnostic methods, uncertainties persist concerning pathophysiological mechanisms, diagnostic criteria and therapeutic attitudes.
Keywords: Fungal sinusitis – Imaging – Endoscopic surgery – Anti-fungal treatment
