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Management of fungal sinusitis: A retrospective study in a medical college hospital

Sudhir M Naik , Ravishankar S , Deekshith R M , Sherry J , Pooja N , Shashikumar T , Shankarna-rayan Bhat ,Navya R , Aishwarya K C

Background/ objectives: Fungus balls are ex-tra-mucosal collections of fungal elements, usually localized to a single sinus cavity, com-monly the maxillary sinus. They appear as partial or complete heterogeneous opacifica-tion of the involved sinus with occasional metal dense opacities on CT scan. Here we report a case series of fungal sinusitis with multiple sinus involvement.

Materials and methods: We report a case series analysis of 46 cases of fungal sinusitis managed in our department for the past 3 years. Mean age in our study group was 32.45 years, with 15 males (mean age – 35.46 yrs) and 31 females ( mean age –31 yrs). All were operated with endoscopic sinus surgery after CT findings posi-tive of fungal sinusitis.

Result: Fungal ball was seen in 36 (78.26%) cas-es and invasive fungal sinusitis were seen in 8 (17.39%)cases. 4 cases did not yield any growth and only secondary bacterial infection were seen on bacterial culture. 34 cases had disease in the maxillary sinus. 9 cases had bilateral growth and the rest unilateral only. 16 cases had disease in the sphenoid while 6 cases had both maxillary and sphenoid disease. 2 cases had ethmoidal disease.

Conclusion: Endoscopic sinus surgery is treatment of choice for non-invasive fungus ball. Local or sys-temic antifungal therapy are reserved for extensive and invasive fungal diseases.