Updates in the Classification of Fungal Sinusitis

• Published in: Current treatment options in allergy 2023-06, Vol.10 (2), p.93-105
• Main Authors: Lander, Daniel P., Roland, Lauren T.
• Format: Article
• Language: English
• Subjects: Allergens; Allergies; Allergology; Asthma; Classification; Diabetes; Disease; Family Medicine; General Practice; Granulomas; Histopathology; Invasiveness; Medicine; Medicine & Public Health; Patients; Polyps; Rhinosinusitis; Sinuses; Sinusitis; Surgery; Topical Collection on Pediatric Dermatology and Allergy
• ISSN: 2196-3053; 2196-3053
• DOI: 10.1007/s40521-023-00334-9

Purpose of review This review aims to present the current classification schema for fungal rhinosinusitis, highlight current topics of interest, and identify potential areas for improvement and further research. Recent findings There have been recent concerns that the allergic fungal rhinosinusitis (AFRS) criteria may be too stringent, leading to missed diagnoses. Additionally, many individual components of the AFRS criteria are non-specific. A “subacute” or “intermediate” category for invasive fungal sinusitis (IFS) has been proposed in addition to acute and chronic classifications. A new “microinvasive” variant of invasive fungal sinusitis has also been suggested. Recently, there have been reports of progression from non-invasive forms of fungal sinusitis to IFS in immunosuppressed patients. Summary While diagnostic criteria have been published and widely accepted, there is a possibility that fungal sinusitis is a spectrum of disease both in terms of aggressiveness and invasiveness. There is a vast opportunity for multi-institutional studies, translational research, and updates to the classifications and guidelines for fungal sinusitis.