A Clinical Analysis of Fungal Sinusitis

Kim, Soo Whan; Park, Yong Jin; Kim, Sung Won; Kang, Min Gon; Joo, Young Hoon; Cho, Jin Hee

Abstract

BACKGROUND AND OBJECTIVES
Since its first recognition in 1885 by Schubert, the prevalence of human fungal sinusitis has increased. Recently, endoscopic sinus surgery has emerged as a successful surgical modality in the treatment of fungal sinusitis. In this study, we aimed to investigate the clinical characteristics of fungal sinusitis and evaluate the efficacy of endoscopic sinus surgery (ESS) for treating fungal sinusitis. SUBJECTS AND METHOD: Of the 8750 cases who underwent ESS between 1995 and 2003, 157 cases that were pathologically confirmed to be fungal sinusitis were retrospectively analyzed by reviewing their medical records. RESULTS: There were 52 males and 105 females patients: the age ranged from 14 to 88 years, with the mean age of 54 years. The peak incidence was found in the 70's. The most common chief complaints were nasal obstruction (44%). The number of human fungal sinusitis treated with ESS were 41 from 1995 to 1998, and 116 since 1999. Recently, the number of cases has increased. The radiological findings in these cases included haziness, calcification and bone destruction of the involved sinuses. Preoperative CT revealed mottled calcific densities within involved sinuses in 37% of the cases. During operation, fungal ball and debris were observed in 52 cases and nasal polyps in 58 cases. All patients received ESS and showed no recurrence during the mean follow-up period of 6.2 months. CONCLUSION: The review of 157 cases of fungal sinusitis revealed that the incidence was increased recently, symptoms were non-specific, CT and nasal endoscopy were excellent diagnostic tools, and that the ESS is a good modality for treatment.