Clinicopathological and microbiological study of fungal rhinosinusitis treated with endoscopic surgery

Abstract

Objective: The objective of this study was to analyse the aetiology, clinical presentations, histopathology and microbiological aspects of fungal rhinosinusitis (FRS) in patients undergoing endoscopic surgery. Methods: The descriptive study was carried out over a 4-year period in two Serbian ENT Clinics and included patients with sinonasal pathology who underwent endoscopic surgery. Results: The study included 26 patients. The most common forms of FRS treated by endoscopic sinus surgery was allergic FRS (AFRS). The fungus identification rate varied between entities, and was 72.2% in AFRS and 33.3% in fungal ball specimens. The common species seen in AFRS isolates were Cladosporium spp. (38.5% of isolated) and dematiaceous molds in the same percentage, while the remainder of the cultures were hyaline moulds. CT scan can be very helpful in diagnosing FRS and sometimes even in differentiating between different entities. Treatment of FRS should be tailored for each entity. Postoperative medical treatment in AFRS should consider potential advancements described in the literature. Conclusions: This study emphasises the need to combine all types of clinical, radiology, pathohistological and microbiological methods to obtain the best diagnostic and treatment strategies and should be the basis for further research. Copyright © 2025 Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale, Rome, Italy.