Endoscopic surgery for mycotic and chronic recurring sinusitis.

Area of Science:

• Otolaryngology
• Mycology
• Surgical Innovation

Background:

• Fungal sinusitis, frequently linked to Aspergillus species, can cause severe complications.
• Chronic sinusitis often creates conditions for secondary fungal infections in the sinuses.
• Infection typically spreads from the anterior ethmoid to larger sinuses like the maxillary and frontal.

Purpose of the Study:

• To describe an endoscopic surgical technique for treating mycotic sinusitis.
• To evaluate the efficacy of this technique in managing fungal infections of the sinuses.
• To highlight the importance of addressing the ethmoid sinus in treating recurrent sinusitis.

Main Methods:

• Identification of stenotic or infected anterior ethmoid areas using CT scans.
• Endoscopic endonasal surgery to remove diseased mucosa and widen sinus passages.
• Enlargement of the natural maxillary sinus ostium to facilitate fungal mass removal.

Main Results:

• The developed endoscopic technique successfully treated over 140 patients with mycotic sinusitis.
• Dependent sinuses (maxillary, frontal) often healed spontaneously post-ethmoid surgery.
• Direct treatment of sinus mucosa was typically unnecessary, with mycotic masses removed via the enlarged ostium.

Conclusions:

• Endoscopic surgery of the anterior ethmoid is a key element in treating mycotic sinusitis.
• This approach effectively manages fungal sinusitis by addressing the primary source of infection.
• The technique offers a minimally invasive solution with potential for spontaneous healing of affected sinuses.