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

Background/ objectives: Fungus balls are extra-mucosal collections of fungal elements, usually localized to a single sinus cavity, commonly the maxillary sinus. They appear as partial or complete heterogeneous opacification 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 positive of fungal sinusitis. Result: Fungal ball was seen in 36 (78.26%) cases 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 systemic antifungal therapy are reserved for extensive and invasive fungal diseases.