Complicated fungal sinusitis. Clinical and therapeutic aspects.

Fungal infections of the sinuses are becoming more common and increasing number of cases are being reported in immunocompetent patients. Unfortunately a significant number of cases present with a complication. In this review of 140 patients with fungal sinusitis, 16 (11.4%) presented with an extrasinus, orbital or intracranial complication. The different fungal types, presentation and therapeutic approaches are discussed. This emphasizes the need for vigilance in dealing with patients with atypical sinus disease and to suspect fungal infections pre- and intraoperatively. Combined surgical and long term medical treatments are usually needed to prevent recurrences and spread of the infection.