An algorithmic approach to aspergillus sinusitis

• Published in: Journal of laryngology and otology Vol. 108; no. 4; p. 314
• Main Authors: de Carpentier, J P, Ramamurthy, L, Denning, D W, Taylor, P H
• Format: Journal Article
• Language: English
• Published: England 01.04.1994
• Subjects: Algorithms; Amphotericin B - therapeutic use; Aspergillosis - diagnostic imaging; Aspergillosis - drug therapy; Aspergillosis - surgery; Aspergillosis - therapy; Humans; Immunocompromised Host; Paranasal Sinus Diseases - diagnostic imaging; Paranasal Sinus Diseases - drug therapy; Paranasal Sinus Diseases - surgery; Paranasal Sinus Diseases - therapy; Paranasal Sinuses - surgery; Tomography, X-Ray Computed
• ISSN: 0022-2151
• DOI: 10.1017/S0022215100126635

The effective management of paranasal sinus aspergillosis requires early diagnosis, histological classification, surgery and where appropriate, chemotherapy. Fungal sinusitis may be easily missed unless a high index of suspicion is maintained and specific culture and histology requested. The disease is classified into invasive and noninvasive types, each being divided into two subgroups: invasive aspergillosis may be either fulminant or indolent and noninvasive disease localized or allergic. The literature is reviewed and an algorithmic approach to aspergillus sinusitis proposed. The importance of histologically differentiating invasive from noninvasive aspergillosis prior to selecting the appropriate treatment options is stressed. CT scan should precede definitive surgery, and be used in follow-up. Close and prolonged follow-up is essential.