Diagnostic and therapeutic aspects of chronic maxillary sinusitis caused by fungal infections: A review of the literature.

Abstract

RELEVANCE OF THE PROBLEM AND AIM OF THE WORK. Chronic fungal maxillary sinusitis is an increasingly diagnosed condition in clinical practice. The diagnostic and therapeutic processes remain complex due to the nonspecific nature of clinical manifestations and the absence of standardized management protocols. The objective of this study is to assess the reliability and efficacy of current diagnostic and therapeutic methods based on recent scientific evidence.

Materials and methods: A systematic literature review was conducted following PRISMA guidelines. PubMed, ScienceDirect, and Cochrane Library were searched for English-language articles (2016-2024) on diagnostic and therapeutic approaches for chronic fungal maxillary sinusitis.

Results: The analysis revealed that diagnostic and treatment strategies for chronic fungal sinusitis depend on the clinical form. MRI and histopathology proved most accurate for diagnosing invasive sinusitis, while CT was more suitable for non-invasive types. Clinical symptoms were common but not specific enough for definitive diagnosis. Surgical treatment alone was effective for non-invasive cases, whereas invasive forms required both surgery and antifungal therapy. Allergic fungal sinusitis was primarily managed with systemic corticosteroids.

Conclusions: Effective management of chronic fungal maxillary sinusitis relies on accurate classification of the disease form. Radiological imaging and histological analysis are the most reliable diagnostic methods. Treatment should be form-specific: surgery for non-invasive cases, combined surgical and antifungal therapy for invasive forms, and corticosteroids for allergic fungal sinusitis.