Invasive Fungal Rhinosinusitis: Clinical Features, Imaging Findings, and Treatment Outcomes

Invasive fungal rhinosinusitis (IFRS) encompasses a spectrum of aggressive fungal infections that involve the sinonasal tract and potentially extend into surrounding structures. This article reviews current knowledge on IFRS, focusing on clinical presentation, diagnostic modalities (particularly the role of gadolinium-enhanced MRI), prognostic factors, and treatment outcomes. IFRS can be categorized into acute, chronic, and chronic granulomatous types based on their clinical progression and histopathological characteristics. Despite advances in medical and surgical management, mortality rates remain significant. Loss of contrast enhancement on MRI reveals tissue ischemia secondary to angiocentric fungal invasion and serves as a critical prognostic marker. Complete surgical debridement of necrotic tissues, systemic antifungal therapy, and correction of underlying immunocompromising conditions are essential components of treatment. This review aims to provide clinicians with the updated current understanding of IFRS, with a focus on early diagnosis and appropriate management to enhance patient outcomes.