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The mold conundrum in chronic hyperplastic sinusitis

Fenna A Ebbens1, Christos Georgalas, Wytske J Fokkens

  • 1Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands. f.a.ebbens@amc.uva.nl

Current Allergy and Asthma Reports
|February 13, 2009
PubMed

Insights

The role of fungi in chronic rhinosinusitis (CRS) is unclear, as fungi are found in both patients and healthy individuals. Current evidence does not definitively prove fungal involvement in CRS pathogenesis or the effectiveness of antifungal treatments.

Area of Science:

  • Otolaryngology
  • Mycology
  • Immunology

Background:

  • Fungi are frequently detected in the nasal passages and paranasal sinuses of individuals with chronic rhinosinusitis (CRS).
  • The presence of fungi is not exclusive to CRS patients, as they are also found in healthy individuals.
  • Existing theories propose mechanisms for fungal impact on sinus mucosa in susceptible individuals.

Purpose of the Study:

  • To investigate the unclear role of fungi in the pathogenesis of chronic rhinosinusitis.
  • To identify potentially pathogenic fungal species implicated in CRS.
  • To characterize the specific immunologic responses to fungi that may contribute to CRS development.

Main Methods:

  • Detection of fungal presence in nasal and sinus cavities of CRS patients and healthy controls.
  • Review of existing theories on fungal mechanisms affecting sinus mucosa.
  • Evaluation of immunologic data and clinical outcomes following antifungal therapy.

Main Results:

  • Fungi are ubiquitously detected in both CRS patients and healthy controls.
  • Convincing immunologic data linking fungi to CRS pathogenesis is currently lacking.
  • Clinical evidence supporting improvement in CRS after antifungal therapy is not established.

Conclusions:

  • The pathogenic role of fungi in chronic rhinosinusitis remains unproven.
  • Further research is required to elucidate fungal involvement and host immune responses in CRS.
  • Antifungal therapy efficacy in CRS is not supported by current evidence.

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