Fungal rhinosinusitis
Year: 2009
Type: review
Abstract: BACKGROUND: Fungal (rhino-) sinusitis encompasses a wide spectrum of immune and pathological responses, including invasive, chronic, granulomatous, and allergic disease. However, consensus on terminology, pathogenesis, and optimal management is lacking. The International Society for Human and Animal Mycology convened a working group to attempt consensus on terminology and disease classification. DISCUSSION: Key conclusions reached were: rhinosinusitis is preferred to sinusitis; acute invasive fungal rhinosinusitis is preferred to fulminant, or necrotizing and should refer to disease of <4 weeks duration in immunocompromised patients; both chronic invasive rhinosinusitis and granulomatous rhinosinusitis were useful terms encompassing locally invasive disease over at least 3 months duration, with differing pathology and clinical settings; fungal ball of the sinus is preferred to either mycetoma or aspergilloma of the sinuses; localized fungal colonization of nasal or paranasal mucosa should be introduced to refer to localized infection visualized endoscopically; eosinophilic mucin is preferred to allergic mucin; and allergic fungal rhinosinusitis (AFRS), eosinophilic fungal rhinosinusitis, and eosinophilic mucin rhinosinusitis (EMRS) are imprecise and require better definition. In particular, to implicate fungi (as in AFRS and EMRS), hyphae must be visualized in eosinophilic mucin, but this is often not processed or examined carefully enough by histologists, reducing the universality of the disease classification. A schema for subclassifying these entities, including aspirin-exacerbated rhinosinusitis, is proposed allowing an overlap in histopathological features, and with granulomatous, chronic invasive, and other forms of rhinosinusitis. Recommendations for future research avenues were also identified.
Source: The Laryngoscope
DOI: 10.1002/lary.20520
Authors: Arunaloke Chakrabarti, David W. Denning, Berrylin J. Ferguson, Jens Ponikau, Walter Buzina, Hirohito Kita, Bradley Marple, Naresh Panda, Stephan Vlaminck, Catherine Kauffmann‐Lacroix, Ashim Das, Paramjeet Singh, Saad J. Taj‐Aldeen, A. Serda Kantarcioglu, Kumud K. Handa, Ashok Gupta, M. Thungabathra, Mandya R. Shivaprakash, Amanjit Bal, Annette Fothergill, Bishan D. Radotra
Institutions: Post Graduate Institute of Medical Education and Research, University of Manchester, Manchester University NHS Foundation Trust, University of Pittsburgh, University at Buffalo, State University of New York, Medical University of Graz, Mayo Clinic, The University of Texas Southwestern Medical Center, AZ Sint-Jan, Centre Hospitalier Universitaire de Poitiers, Hamad Medical Corporation, Istanbul University-Cerrahpaşa, Istanbul University, All India Institute of Medical Sciences, The University of Texas at San Antonio Health Science Center
Language: English
Subfield: Otorhinolaryngology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1978569335