Aspergillus sinusitis: clinical aspects and treatment outcomes

Area of Science:

• Otolaryngology
• Mycology
• Infectious Diseases

Background:

• Aspergillus sinusitis is a fungal infection affecting the paranasal sinuses.
• Understanding its types, clinical presentation, and imaging characteristics is crucial for diagnosis and management.

Purpose of the Study:

• To analyze the characteristics of primary and secondary Aspergillus sinusitis.
• To evaluate imaging findings, disease extent, and treatment outcomes.

Main Methods:

• Retrospective analysis of 72 cases of Aspergillus sinusitis diagnosed between January 1980 and October 1993.
• Review of clinical data, computed tomography (CT), and magnetic resonance imaging (MRI) findings.
• Assessment of treatment modalities and patient outcomes.

Main Results:

• Sixty cases were primary and 12 were secondary Aspergillus sinusitis.
• Maxillary and ethmoid sinuses were most commonly involved; sphenoid sinus was frequent in secondary type.
• Sinus wall destruction occurred in 23% of primary and 33% of secondary cases.
• Fungal material appeared as increased attenuation on CT and altered signal intensities on MRI.
• 98% of primary and 83% of secondary cases were noninvasive.
• Diabetes mellitus was the most common comorbidity in secondary cases.
• Thickened mucosa with necrotic material was a common finding.
• Surgery was the primary treatment, with 4 patients receiving adjuvant chemotherapy.
• All patients achieved cure without recurrence.

Conclusions:

• Aspergillus sinusitis, predominantly noninvasive, affects sinuses like maxillary and ethmoid.
• Imaging plays a key role in identifying sinus wall destruction and fungal burden.
• Surgical management is effective, with good outcomes and low recurrence rates.