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Dematiaceous fungal sinusitis

L A Zieske1, R D Kopke, R Hamill

  • 1Department of Surgery, Tripler Army Medical Center, HI 96859-5000.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|October 1, 1991
PubMed

Insights

Dematiaceous fungal sinusitis, often unilateral, presents unique CT/MRI findings. Combined surgical and antifungal therapy significantly reduces recurrence and complications compared to surgery alone.

Area of Science:

  • Medical Mycology
  • Otolaryngology
  • Radiology

Background:

  • Dematiaceous fungal sinusitis is a rare but significant clinical entity.
  • Understanding its presentation and optimal treatment is crucial for patient outcomes.

Observation:

  • Six new cases and 33 literature cases of dematiaceous fungal sinusitis were reviewed.
  • Sinusitis was frequently unilateral, with characteristic CT (serpiginous hyperdense opacification, bone erosion) and MRI (T1/T2 hypointense) findings.
  • Invasive histologic features were noted in some cases.

Findings:

  • Combined surgical treatment and systemic antifungal therapy demonstrated lower recurrence and complication rates than surgery alone.
  • While not statistically significant, a trend towards increased recurrence and complications was observed with surgery alone, especially with invasive histology.

Implications:

  • Comprehensive surgical management followed by systemic antifungal therapy is recommended for dematiaceous fungal sinusitis.
  • Individualized treatment plans are essential, considering clinical judgment.
  • Further research is needed to fully elucidate this disease and refine therapeutic strategies.

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