Fungal Sinusitis and Treatment

Document Type : Original Article(s)

Authors

1 Associate Professor, Department of Otolaryngology, School of Medicine, Isfahan University of Medical Sciences, Isfahan

2 Resident of Otolaryngology, Department of Otolaryngology, School of Medicine, Isfahan University of Medical Sciences, Isfahan

3 Professor, Department of Otolaryngology, School of Medicine, Isfahan University of Medical Sciences, Isfahan

Abstract

Background: We report the diagnosis, treatment and follow–up process of 22 cases of fungal sinusitis.

Methods: This case- series study was carried out on 22 patients with fungal sinusitis that had treatment of endoscopy and antifungal drug. Past medical history, pathology, CT scan findings and treatment of patients were evaluated. Data analysis was done using SPSS.

Findings: Twelve male (57%) and 10 female (43%) patients with the age of 16-73 years were a ssessed. Mucormycosis was seen in 18 (82%) and Aspergilosis in 4 (18%) patients. Diabetic mellitus (71%), chronic renal failure (CRF) (14.3%), and leukemia (9.6%) were reported as the most common underlying diseases. Maxillary and etmoid sinuses were the site of involvement. The most common sign was unilateral periorbital edema and proptosis (95%), and the most common symptom was unilateral change of visual acuity and cheek sensation (95%). All the patients had endoscopy surgery and treated with amphotricine B or ithraconazole and ceftrinaxone, metronidazole and vancomycine. Death was reported in 5 patients (22%) and renewed functional endoscopic sinus surgery (FESS) in 1 (4.8%).

Conclusion: Functional endoscopic sinus surgery with amphotncine B or ithraconazole and follow-up are effective for fungal sinusitis.

Key words: Fungal sinusitis, Amphotericin, Sinus endoscopy.