Classification of fungal sinusitis in immunocompetent patients

• Published in: Otolaryngology-head and neck surgery 2003-10, Vol.129 (4), p.372-378
• Main Authors: Uri, Nechama, Cohen-Kerem, Raanan, Elmalah, Irit, Doweck, Illana, Greenberg, Elhanan
• Format: Article
• Language: English
• ISSN: 0194-5998; 1097-6817
• DOI: 10.1016/S0194-5998(03)01304-4

The objective of this study was to review the subgroup classification of fungal sinusitis in immunocompetent patients. The study design included 19 immunocompetent patients with fungal sinusitis who were operated on between 1993 and 1998. Ten of 19 patients showed a fungus ball. They underwent a limited surgical endoscopic procedure, and no further treatment was needed. Four patients had allergic fungal sinusitis and were treated postoperatively with irrigation, topical steroids, and oral steroids in 2 patients as well. Five patients had chronic sinusitis with significant bone erosion. All 5 underwent an extensive endoscopic procedure and were treated postoperatively by repeated irrigation, endoscopic cleaning, and no antifungal preparation. Two patients of this group are reported broadly. Fungal sinusitis in immunocompetent patients is not a rare condition and can be divided into 3 categories: 1) fungus ball, 2) chronic erosive (noninvasive) fungal sinusitis, and 3) allergic fungal sinusitis. The symptomatology, treatment, and prognosis varied significantly among the 3 different categories.