Chronic fungal rhinosinusitis

Abstract

Introduction: Fungal rhinosinusitis, long regarded as a rare pathology, is recognized and reported with increasing frequency in the last two decades throughout the world.The purpose of the paper is to highlight the characteristics of chronic fungal sinusitis and determine fungal ball’s etiological, pathological, clinical and treatment aspects.

Materials and Methods: To achieve the objectives of the work was carried out a study which included 12 patients diagnosed with fungal-ball, hospitalized in Otorhinolaryngology Department of the Municipal Hospital "Sfinta Treime" during the period 2014-2015, data were taken from observations sheets of patients in hospital archive. For statistical processing of the data was used Microsoft Office Excel 2013.

Results: According to the distribution of patients by age, we find that 41.66% who are aged between 50-55 years suffer from fungal-ball, between 45-50 years-25%, between 40-45 years-16.66% of patients. Meets lower incidence in patients aged 35-40 years and 25-35 years- 8.33% each of all patients with mycetoma. At the age up to 25 years it has not been found no patient with mycetoma. According to the distribution of patients by gender, there was a predominance of the female- 66.66%, the male gender- 33.33%. According to the involved sinus, we find that most commonly affected is the maxillary sinus, being affected in 75%, followed by sphenoid sinus which was affected in 16.66%, only 8.33% was found the affection of ethmoidal sinus. The frontal sinus was not affected in any patient of these examined. Based on the batch of 12 patients, we observed specific symptoms of mycetoma: facial pain, encountered in all patients- 100%, followed by difficult nasal breathing- 91.66%, rhinorrhea- 83.33%, headache- 75%, anosmia- 58.33%, cough-16.66%, epistaxis- 8.33%. Has revealed that the pathogen most often implicated in the appearance of mycetoma is Aspergillus fumigates, met in 75%, followed by Aspergillus Niger- 16.66%, and Aspergillus Flavus- 8.33%.

Conclusions: Fungal rhinosinusitis has approximately 10% of patients requiring surgery on the nasal cavity and sinuses, and between 13.5 and 28.5% of all sinusitis are caused by fungi or combination of bacteria and fungi. I noticed that mycetoma meets more often in older people, between 45-55 years. By gender, it was observed a predominance of the female gender (2: 1). According localization is determined that most often affected is maxillary sinus. From the obtained results we concluded that the most common symptoms are: facial pain, difficult nasal breathing, rhinorrhea, headache; the most rarely encountered are anosmia, cough; and from the nonspecific rarely encountered it is epistaxis. Mycological examination revealed that the pathogen most often implicated in the appearance of mycetoma is Aspergillus fumigates.