Abstract
BackgroundChronic and granulomatous invasive fungal rhinosinusitis are important causes of blindness and craniocerebral complications. However, the classification of these 2 diseases remains controversial.MethodsWe retrospectively analyzed patients with chronic and granulomatous invasive fungal rhinosinusitus in a Chinese tertiary hospital from 2009 to 2017, with a focus on classification and comparisons.ResultsAmong 55 patients enrolled in our study, 11 (11/55, 20%) had granulomatous invasive fungal rhinosinusitis (GIFRS) and 44 (44/55, 80%) had chronic invasive fungal rhinosinusitis (CIFRS). Aspergillus fumigatus and Dematiaceous hyphomycetes were identified in 2 patients with GIFRS. Compared with granulomatous type, CIFRS was more frequently encountered in immunocompromised patients (P = .022), and the time from onset to diagnosis was much shorter (P = .001). Proptosis and orbital apex syndrome showed no significant difference between granulomatous and CIFRS in our study. The treatment options and prognosis of both diseases also showed no significant difference.ConclusionsDespite the consensus on histopathology, the classification of the chronic and granulomatous types may need further evaluation in clinical considerations.
Highlights
MethodsWe retrospectively analyzed patients with chronic and granulomatous invasive fungal rhinosinusitus in a Chinese tertiary hospital from 2009 to 2017, with a focus on classification and comparisons
Chronic and granulomatous invasive fungal rhinosinusitis are important causes of blindness and craniocerebral complications
Though much debate exists on its classification, the most commonly accepted system divides fungal rhinosinusitis broadly into 2 groups: invasive and noninvasive according to the histopathological findings
Summary
We retrospectively analyzed patients with chronic and granulomatous invasive fungal rhinosinusitus in a Chinese tertiary hospital from 2009 to 2017, with a focus on classification and comparisons. This was a retrospective observational study conducted from January 2009 to August 2017 at Huashan Hospital, a tertiary hospital in Shanghai, China. Patients who were pregnant, who presented with acute onset (a time course of less than 4 weeks), and without complete data were excluded. Data were collected through medical records, including basic characteristics, predisposing factors, symptoms and signs, laboratory investigation results, image findings (including paranasal sinus computed tomography and cranial magnetic resonance imaging findings), pathological results, antifungal regimens, and patient outcomes.
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