A Study on the Prevalence and Clinical Features of Fungal Sinusitis in Chronic Rhinosinusitis

Abstract

Chronic sinusitis is a common disorder worldwide a significant proportion of which is secondary to fungal aetiology contrary to popular belief that fungal sinusitis is a rare entity, more so in a country like India where warm moist climate in a number of states and ever rising incidence of diabetes mellitus gives the fungal organisms a perfect environment to grow. This study aims to find the incidence and clinical features of fungal rhinosinusitis in chronic rhinosinusitis reinstating the fact that it should be kept as a differential diagnosis in every patient presenting with symptoms of chronic rhinosinusitis. Aim of the study was to find out the incidence and clinical manifestations of fungal sinusitis in chronic rhinosinusitis. A prospective study was conducted in JSS Academy of Higher Education and Research, Mysore during a time period of 37 months i.e. November 2015 to December 2018. Total of 190 patients with chronic rhinosinusitis were evaluated with relevant investigations to reach the diagnosis. All patients were subjected to diagnostic nasal endoscopy and CT scan of paranasal sinuses. Patients were then subjected to functional endoscopic sinus surgery and sample collected was sent for KOH stain and fungal culture with histopathology. Fungal rhinosinusitis is on the rise now and it is important to evaluate all cases with caution and keep an eye out for features suggestive of fungal sinusitis as an accurate diagnosis is the key to proper management.

Keywords: Diagnostic nasal endoscopy; Functional endoscopic sinus surgery; Prospective study.

Fig. 1

Distribution of cases based on diagnostic nasal endoscopy findings

Fig. 2

Symtomatology of fungal sinusitis

Fig. 3

A CT scan, coronal view of the paranasal sinuses showing fungal rhinosinusitis of the left maxillary sinus with metal dense deposits

Fig. 4

Allergic mucin in the left nasal cavity