Characteristics of patients with diagnosed chronic fungal rhinosinusitis surgically treated in the past five years

Abstract

Introduction/Objective Fungal rhinosinusitis comprises of a wide range of immune-pathological responses, including invasive, chronic, granulomatous, and allergic diseases. Aim of this study was to determine total number of patients, their characteristics, frequency of symptoms, the manner of disease manifestation and the success of therapy.

Methods Study included 21 patients with fungal rhinosinusitis diagnosis made according to the 2020 EPOS guidelines.

Results Based on the visual analogue scale, feeling of localized pressure, i.e., facial pain, was dominant with a score of 9.57 ± 0.98, followed by the secretion from the nose with 8.14 ± 1.62, problems with breathing through the nose with 6.67 ± 3.25, and reduction the sense of smell with 2.14 ± 3.00. The t-test showed a statistically significant difference between mucosal changes on the diseased and healthy sides of the patient‘s face (p < 0.0001). Only one sinus was affected intraoperatively in 18 (85.71%) patients. The most commonly affected sinus was the maxillary one, in 13 (54.17%) patients, followed by the sphenoid sinus in five (20.83%) patients. Aspergillus was proven аs the couse of rhinosinusitis in 12 (57.14%) patients.

Conclusion The dominant symptom of patients with fungal rhinosinusitis was localized pain/pressure in the area of the affected sinus. Endoscopically, on the side of the affected sinus, the pathological mucosa with thick, pithy, mucous secretion dominated. The maxillar sinus was primarily unilaterally affected, in more than half of the patients. Aspergillus has been proven to be the most common cause of rhinosinusitis.

Keywords: fungal rhinosinusitis; chronic rhinosinusitis; headache; facial pain/pressure; nasal discharge; nasal obstruction