Clinical Spectrum, Diagnostic Approaches, and Treatment Outcomes of Invasive Fungal Sinusitis: A Combined Retrospective and Prospective Study from South India

Background: Invasive fungal sinusitis is a serious condition with high morbidity and mortality, particularly in immunocompromised patients in tropical regions. This study aimed to assess modes of presentation, complications, diagnostic approaches, and treatment outcomes of invasive fungal sinusitis.

Materials and Methods: A combined retrospective and prospective observational study was conducted at the Upgraded Institute of Otorhinolaryngology, Rajiv Gandhi Government General Hospital, Chennai, from March 2025 to February 2026. Thirty adult patients with histopathologically or culturally confirmed invasive fungal sinusitis (acute, chronic, and chronic granulomatous subtypes) were included. Data on demographics, clinical features, predisposing factors, endoscopic findings, imaging, microbiology, management, and outcomes were analyzed using SPSS version 27.0.

Results: The mean age was 48 years with male predominance (67%). Diabetes mellitus was the predominant predisposing factor (87%). Mucorales were isolated in 83% of acute and chronic invasive cases, while Aspergillus predominated in chronic granulomatous cases. Intraorbital complications occurred in 73% of patients. Combined antifungal therapy and surgical debridement led to clinical improvement in 77% of cases, with an overall mortality rate of 23%.

Conclusion: Invasive fungal sinusitis predominantly affects middle-aged diabetic males and carries significant risk of orbital complications. Early diagnosis through nasal endoscopy and biopsy, followed by aggressive multimodal management, can improve outcomes. Heightened awareness and timely intervention are crucial in high-prevalence regions.