Background & Objectives: Rhinosinusitis comprises a spectrum of inflammatory and infectious disease that involves the sinuses and nasal mucosa which affects approximately 20% of the population. Fungi are being increasingly implicated in the etiopathology of rhinosinusitis& its clinical presentation is almost indistinguishable from that of chronic rhinosinusitis. The aim of this study is to determine the proportion of fungal sinusitis among diagnosed cases of chronic rhinosinusitis and to describe the clinical, radiological, microbiological and pathological profile.

Methods: 186 Chronic rhinosinusitis patients were included in the study after fulfilling the inclusion and exclusion criteria. This study was conducted at Department of ENT, Medical College, Thiruvananthapuram over a period of 13 months. After obtaining informed written consent, detailed history and clinical examination was performed and investigation findings were noted. After surgery, the histopathological, fungal stain and culture results of the tissue samples send were analysed statistically using SPSS software.

Results & Discussion: Out of 186 cases of chronic rhinosinusitis, 50 cases (26.9%) were found to be fungal culture positive. Among them 29(58%) were caused by Aspergillus species. Headache, nasal obstruction and nasal discharge were the most common presenting symptoms of these cases. Radiological features like double density, sclerosis, bone erosion, and unilateral affection of the disease were found to be significantly associated with fungal sinusitis cases.

Conclusion: The early diagnosis and recognition of fungal sinusitis is very important, not only because it is curable in the early stages, but also to prevent progression of the disease into more destructive invasive forms. Aspergillus species is the most common culprit causing fungal sinusitis. CT scan plays a very important role & is one of the best diagnostic tools in diagnosing fungal rhinosinusitis.

Keywords: Fungal rhinosinusitis, Aspergillus, culture, KOH mount, radiological, chronic rhinosinusitis, endoscopic sinus surgery.

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Dr Sindhu V Nath

12 Vasanth Vihar, Kumarapuram, Trivandrum, Kerala 695011, India