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Fungal Sinusitis: Radiological Aspects

Marrakchi Jihène, Mejbri Maha, Meherzi Samia, Rim Zainine, Ben Amor Mohamed, Myriam Jrad, Houda Chahed, Azza Mediouni, Rim Bechraoui, Habiba Mizouni, Najeh Beltaief and Ghazi Besbes

Introduction: Fungal sinusitis is a well-known entity. They are grouped into invasive forms and non-invasive forms. The diagnosis is often late and difficult given the varied and non-specific nature of the clinical signs. Invasive forms, which cause serious complications that are life-threatening, require rapid diagnosis. The objective was to illustrate the different radiological aspects of fungal sinusitis by specifying for each group its clinical and anatomo-mycological particularities.

Methods: This was a retrospective study of 30 cases of fungal sinusitis collected in service over a 20-year period (1998-2017). All patients had an imaging.

Results: Our series included 30 cases divided into 16 cases of fungal ball, 5 cases of allergic form, 5 cases of chronic invasive fungal sinusitis and 4 cases of mucormycosis. A female predominance was noted with a sex ratio of 0.3. The clinical picture was nonspecific. The functional signs were dominated by rhinorrhea, nasal obstruction and facial pain. Imaging, based on CT (Computed tomography) and/or MRI, was performed in all patients. The radiological signs varied according to the type of fungal attack. All patients were operated on. The diagnosis was mycological and/ or pathological.

Conclusion: The clinical picture of fungal sinusitis is nonspecific. However, one must know how to think of the invasive forms before any trailing sinusitis on a field of immunodepression. Imaging is of great value in the diagnostic and therapeutic approach.