Abstract
Fungal infections are a subset of infectious processes that an otolaryngologist is required to be familiar with. They can be encountered in otology, rhinology and head and neck surgery. The presence of fungal rhinosinusitis is well recognised by otolaryngologists, but the classifications and appropriate management are not so well understood. The prevalence of fungal sinus disease is thought to be have been increasing in recent decades There is speculation that this may be due to increased awareness, antibiotic overuse and increased use of immunosuppressant medications. Added to this, there has been a large amount published on the role of fungi as a causative organism in chronic rhinosinusitis. Given the importance of fungal rhinosinusitis in clinical practice, we aim to review the classification and current management strategies based on up-to-date literature.
Highlights
Given the importance of fungal rhinosinusitis in clinical practice, we aim to review the classification and current management strategies based on up-to-date literature
Diagnosis: allergic fungal rhinosinusitis (AFRS) is often suspected in the setting of a patient who is resistant to the routine treatments, including surgical intervention, for chronic rhinosinusitis (CRS)
The impact of fungi in the upper airways is wider than just its role in fungal sinusitis
Summary
Fungal infections are one of the four major microbiological sub-groups. Fungi can take two different forms. The less commonly encountered, but known for their invasive potential, are fungi of the Zygomycota order (Mucor, Rhizopus, Apophysomyces et al.). These fungi are often implicated in immunocompromised individuals, as in the case of Mucormycosis [4]. Fungal spores are abundant in the atmosphere and so readily encounter anatomical structures relevant to ENT surgeons. These fungi, only develop pathological potential if the environment is suitable for this. Fungi that are inhaled form part of the normal sinonasal flora These fungi are destroyed by normal functioning immunological cascades. Following the prolonged use of antibiotics, poor ventilation, dark and moist environments as well as immunocompromise, these immunological pathways are disrupted, making fungal infections more likely [3]
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