Abstract

Radiological images of invasive fungal rhinosinusitis (A: coronal, B: sagittal views). Pathohistological image of fungal rhinosinusitis showing oedematous and partially necrotic nasal mucosa with a dilated blood vessel containing fungal elements (arrow) and inflammatory cells. Fungal elements are also seen in close proximity to the blood vessel (*). Haematoxylin and eosin stain, original magnification x200 (C).
Cover figure: Radiological images of invasive fungal rhinosinusitis (A: coronal, B: sagittal views). Pathohistological image of fungal rhinosinusitis showing oedematous and partially necrotic nasal mucosa with a dilated blood vessel containing fungal elements (arrow) and inflammatory cells. Fungal elements are also seen in close proximity to the blood vessel (*). Haematoxylin and eosin stain, original magnification x200 (C).

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.

 

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Authors

Vladan Milutinović - Otorhinolaryngology Clinic, University Medical Center “Zvezdara”, Belgrade, Serbia; Faculty of Dental Medicine, University of Belgrade, Belgrade, Serbia

Aleksandar Trivić - Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, Belgrade, Serbia; Department of Otorhinolaryngology and Maxillofacial Surgery, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Ivana Čolović-Čalovski - Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Jovica Milovanović - Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, Belgrade, Serbia; Department of Otorhinolaryngology and Maxillofacial Surgery, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Sanja Colić - Otorhinolaryngology Clinic, University Medical Center “Zvezdara”, Belgrade, Serbia

Snežana Babac - Otorhinolaryngology Clinic, University Medical Center “Zvezdara”, Belgrade, Serbia; Faculty of Special Education and Rehabilitation, University of Belgrade, Belgrade, Serbia

Nada Tomanović - Institute of Pathology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Zorana Radin - Otorhinolaryngology Clinic, University Medical Center “Zvezdara”, Belgrade, Serbia. Corresponding author - zorana.radin@gmail.com

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Copyright (c) 2024 Società Italiana di Otorinolaringoiatria e chirurgia cervico facciale

How to Cite
Milutinović, V., Trivić, A., Čolović-Čalovski, I., Milovanović, J., Colić, S., Babac, S., Tomanović, N., & Radin, Z. (2025). Clinicopathological and microbiological study of fungal rhinosinusitis treated with endoscopic surgery. ACTA Otorhinolaryngologica Italica, 1–11. https://doi.org/10.14639/0392-100X-N2808
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