Fungal Sinusitis

Dear Colleagues,

Rhinosinusitis represents an array of inflammatory and infectious conditions that primarily affect patient quality-of-life, but may result in substantial morbidity. Fungal organisms are attributable etiologic factors in certain manifestations of rhinosinusitis, both acute and chronic. Allergic fungal rhinosinusitis (AFRS) is a chronic allergic inflammatory response to fungal elements, rather than an infectious process. Diagnostic criteria, proposed by Bent and Kuhn in 1994, include nasal polyposis, eosinophilic mucin, positive staining for fungal elements, and demonstration of type I hypersensitivity reaction. Sinus fungal ball represents an accumulation of fungal debris and inspissated secretions, usually affecting a single paranasal sinus. Endoscopic sinus surgery is typically required in the treatment of both AFRS and sinus fungal ball. Invasive fungal sinusitis (IFS), on the other hand, is an infectious disease where fungal organisms invade the sinonasal mucosa. IFS presents in both acute fulminant and chronic forms. Acute IFS is typically associated with immunocompromise and is a surgical emergency potentially resulting in significant morbidity and mortality. Chronic IFS can present in immunocompetent patients and has a more indolent course. Extensive surgical debridement of the devitalized sinonasal mucosa is usually required to treat this condition. This Special Issue is devoted to exploring fungal sinusitis and will discuss current diagnosis and management of AFRS, IFS, and fungal sinus ball. This issue will also examine novel diagnostic techniques, targeted therapies in the treatment of AFRS, and the use of both topical and systemic antifungal agents in the management of fungal sinusitis.

Dr. Devyani Lal
Dr. Michael Marino
Guest Editors

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