Mycotic Infections - the Possible Cause of Failure of SurgicalTreatment of Maxillary Sinusitis

Overview

The authors analyzed retrospectively a group of 77 adult patients (112 maxillarysinuses) treated by functional endoscopic sinus surgery (FESS) on account of chronic maxillarysinusitis. The group did not include patients with nasal polyposis. In 6 patients of this groupan unilateral revision was indicated on account of persisting symptoms of inflammation in theremainder the fenestra was patent and thus the cause of the persisting inflammation was not poorventilation nor inadequate drainage of the sinuses. In three patients a revision of FESS wasperformed, in another three a combined approach was used involving endoscopy and sinotomy. Inthree patients a mycotic infection was deetected. The diagnosis of mycotic infection was establishedin two patients by cultivation, in one patient histologically. In another patient the diagnosis ofmycosis was very probable. He had a typical surgical finding of lumpy dark secretion in themaxillary sinus and a CT image corresponding to mycotic sinusitis. In that patient the mycosis wasnot confirmed by cultivation nor by histological examination. In two patients mycotic infectionswas not suspected.

Key words:
functional endoscopic sinus surgery, revision, maxillary sinusitis, fungal sinusitis,mycetoma