Paranasal sinus mycoses.

摘要: The incidence of paranasal sinus mycoses (fungal sinusitis) varies widely with higher frequency in Sudan, southwestern states USA and north India, which have hot dry climate. disease has been described as having four types: allergic, non-invasive, invasive fulminate. A possible fifth type: non-invasive destructive may also exist. In a prospective study 176 cases fungal sinusitis from our centre, on the basis clinical, radiological, histopathologic mycologic findings patients could be categorized into: allergic (12), without bone destruction (81), (16), chronic (55) fulminant (12) types. Except fulminate variety, is commonly found young immuno-competent population rural areas. Aspergillus spp. are commonest etiological agents though importance dematiaceous fungi stressed. Zygomycetes common type. series A. flavus (80%) was isolate, followed by A.fumigatus (9.7%), Rhizopus arrhizus (6.3%) Alternaria (1.1%). Curvularia lunata, Apophysomyces elegans Candida albicans were isolated one patient each. Different host environmental factors help lodging causal mucosal plugs these patients. Fungal allergy associated all varieties disease. But it not clear what determines invasion mucosa. Rabbit can used an animal model. Histopathology radio-imaging techniques to distinguish different types delineate extension process. Culture helps identify responsible agent. presence or absence precipitating antibody correlates well progression recovery. For effective management, requires surgical debridement ventilation only. for type need adjuvant medical therapy recommended prevent recurrence further extension. Itraconazole most useful recurrence. Patients require radical surgery immediate chemotherapy.