A Study on Surgical Cases of Fungal Paranasal Sinusitis

In recent years, the number of cases of fungal paranasal sinusitis has been increasing, both due to the increasing number of patients with compromised immune status due to diabetes, malignancy, oral steroid use, etc., as well as the widespread use of imaging tests such as CT and MRI. In this study, we reviewed the data of 100 cases of chronic noninvasive paranasal sinus mycosis treated at Matsuyama Red Cross Hospital between January 2017 and December 2021. The patients comprised of 27 men and 73 women aged 44 to 90 years, with a mean age of 71.9 years. The primary fungal lesion was in the maxillary sinus in 67 patients, in the ethmoid sinus in 1 patient, in the frontal sinus in 1 patient, in the sphenoid sinus in 22 patients, and in multiple sinuses in 9 patients. All patients underwent endoscopic sinus surgery. While cure had been achieved in 89 cases, poor outcomes were obtained in the remaining 11 patients, including persistent mucositis, recurrent sinusitis, and recurrent fungal infections. In 3 cases, a fungal mass was found when the sinuses were surgically opened, whereas the CT had shown only mucosal thickening and the presence of a fungal mass had not been suspected prior to the surgery.