Abstract
BackgroundFungal involvement of the paranasal sinuses has been described more than two centuries ago. In the current article, it is referred to as fungal rhinosinusitis (FRS) which is a general term that is used to describe a spectrum of pathologically, immunologically, and clinically different disease entities affecting the paranasal sinuses where fungus is thought to be the major potential etiology.ObjectiveTo determine the incidence and spectrum of FRS in Singapore and to compare our findings with international figures through literature review.MethodsA retrospective review of the clinical charts, radiological and laboratory results, and operative reports of all patients who underwent endoscopic sinus surgery at an ENT department of a tertiary referral hospital in Singapore over five-year period.ResultsOut of 533 functional endoscopic sinus surgeries performed during the period of the study for management of chronic rhinosinusitis, 44 (8.4%) were found to fit the criteria for diagnosis of FRS. Twenty (45.5%) were eosinophilic FRS and 24 (54.5%) were fungal balls. Invasive FRS has not been encountered. Clinical presentation, investigations, and management of both groups of patients are discussed.ConclusionFungal rhinosinusitis is not uncommon in Singapore. Fungal ball and eosinophilic mucin fungal rhinosinusitis are among the most common forms encountered in this part of the world.
Highlights
Fungal rhinosinusitis (FRS) is not uncommon form of sinonasal pathology [1]
Out of 533 functional endoscopic sinus surgeries performed during the period of the study for management of chronic rhinosinusitis, 44 (8.4%) were found to fit the criteria for diagnosis of fungal rhinosinusitis (FRS)
It was first described by Plaignaud in 1791 when he reported a case of maxillary fungal sinusitis [2]
Summary
Fungal rhinosinusitis (FRS) is not uncommon form of sinonasal pathology [1]. It was first described by Plaignaud in 1791 when he reported a case of maxillary fungal sinusitis [2]. Histopathological classification of FRS into invasive and non-invasive forms is believed to be the most acceptable and clinically applicable method of classification It relies on histological identification of fungal elements within the host tissue in order to define invasiveness [5]. Based on such classification, non-invasive FRS is referred to those fungalrelated sinus conditions which lack histological confirmation of fungal tissue invasion, yet present with a distinctive pathological and clinical features differentiating them from one another. Non-invasive FRS is referred to those fungalrelated sinus conditions which lack histological confirmation of fungal tissue invasion, yet present with a distinctive pathological and clinical features differentiating them from one another Under this form of noninvasive fungal rhinosinusitis comes three discrete pathologies, namely, eosinophilic mucin fungal. It is referred to as fungal rhinosinusitis (FRS) which is a general term that is used to describe a spectrum of pathologically, immunologically, and clinically different disease entities affecting the paranasal sinuses where fungus is thought to be the major potential etiology
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