Systematic Review of Granulomatous Invasive Fungal Sinusitis Management
ABSTRACT Objectives Granulomatous invasive fungal sinusitis (GIFS) affects immunocompetent individuals. There is ongoing debate over whether surgery, antifungal medication, or a combined approach is the best treatment. This article summarizes reports about GIFS and its management. Methods Eight sear...
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| Format: | Article |
| Language: | English |
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Wiley
2025-02-01
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| Series: | Laryngoscope Investigative Otolaryngology |
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| Online Access: | https://doi.org/10.1002/lio2.70086 |
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| author | Abdulsalam Baqays Sarah Almutawa Razan Alsabti Luluh Alsughayer Sandra Campbell Nassr Almaflehi Hussain Albaharana Saad Alsaleh |
| author_facet | Abdulsalam Baqays Sarah Almutawa Razan Alsabti Luluh Alsughayer Sandra Campbell Nassr Almaflehi Hussain Albaharana Saad Alsaleh |
| author_sort | Abdulsalam Baqays |
| collection | DOAJ |
| description | ABSTRACT Objectives Granulomatous invasive fungal sinusitis (GIFS) affects immunocompetent individuals. There is ongoing debate over whether surgery, antifungal medication, or a combined approach is the best treatment. This article summarizes reports about GIFS and its management. Methods Eight search engines, gray literature, and review articles were searched. Two independent reviewer groups screened the eligibility of articles. An independent reviewer solved disagreements. Exclusion criteria included non‐English language reports, papers with unavailable full‐texts, reviews, publications before 1980, and studies lacking information about GIFS management. Results Of the 279 identified articles, 41 studies were included (n = 89 patients). Sinonasal GIFS with skull‐base/intracranial extension was associated with an increase in mortality (p = 0.002, OR = 14.083; 95% CI = 1.753–113.157). Treatment was associated with an 87.2% remission rate (p < 0.001, OR = 7.818; 95% CI = 4.502–13.576); a combined medical and surgical approach had a 74.2% recovery rate. Of surgical interventions, the highest recovery rates were associated with endoscopic debulking (52.5%), extensive surgical debulking (32.5%), and open sinonasal approach (15%, p = 0.132). The utilization of voriconazole was associated with higher recovery rates, but this was not significant (76.9 vs. 56%, p = 0.548). Conclusion Sinonasal GIFS with skull‐base/intracranial extension is associated with higher mortality rates. The superiority of the endoscopic debulking and voriconazole protocol in managing these cases warrants further investigation. Level of Evidence Level 4. |
| format | Article |
| id | doaj-art-25c19d6f09d0426194c1ecf2795c2acf |
| institution | DOAJ |
| issn | 2378-8038 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj-art-25c19d6f09d0426194c1ecf2795c2acf2025-08-20T03:04:53ZengWileyLaryngoscope Investigative Otolaryngology2378-80382025-02-01101n/an/a10.1002/lio2.70086Systematic Review of Granulomatous Invasive Fungal Sinusitis ManagementAbdulsalam Baqays0Sarah Almutawa1Razan Alsabti2Luluh Alsughayer3Sandra Campbell4Nassr Almaflehi5Hussain Albaharana6Saad Alsaleh7Otolaryngology—Head & Neck Surgery Department, College of Medicine King Saud University Riyadh Saudi ArabiaCollege of Medicine King Saud University Riyadh Saudi ArabiaFamily Medicine Department King Faisal Specialist Hospital Riyadh Saudi ArabiaCollege of Medicine King Saud University Riyadh Saudi ArabiaJohn W. Scott Health Sciences Library University of Alberta Edmonton CanadaDepartment of Periodontics and Community Dentistry, College of Dentistry King Saud University Riyadh Saudi ArabiaDepartment of Otolaryngology—Head and Neck Surgery Qatif Central Hospital Qatif Saudi ArabiaOtolaryngology—Head & Neck Surgery Department, College of Medicine King Saud University Riyadh Saudi ArabiaABSTRACT Objectives Granulomatous invasive fungal sinusitis (GIFS) affects immunocompetent individuals. There is ongoing debate over whether surgery, antifungal medication, or a combined approach is the best treatment. This article summarizes reports about GIFS and its management. Methods Eight search engines, gray literature, and review articles were searched. Two independent reviewer groups screened the eligibility of articles. An independent reviewer solved disagreements. Exclusion criteria included non‐English language reports, papers with unavailable full‐texts, reviews, publications before 1980, and studies lacking information about GIFS management. Results Of the 279 identified articles, 41 studies were included (n = 89 patients). Sinonasal GIFS with skull‐base/intracranial extension was associated with an increase in mortality (p = 0.002, OR = 14.083; 95% CI = 1.753–113.157). Treatment was associated with an 87.2% remission rate (p < 0.001, OR = 7.818; 95% CI = 4.502–13.576); a combined medical and surgical approach had a 74.2% recovery rate. Of surgical interventions, the highest recovery rates were associated with endoscopic debulking (52.5%), extensive surgical debulking (32.5%), and open sinonasal approach (15%, p = 0.132). The utilization of voriconazole was associated with higher recovery rates, but this was not significant (76.9 vs. 56%, p = 0.548). Conclusion Sinonasal GIFS with skull‐base/intracranial extension is associated with higher mortality rates. The superiority of the endoscopic debulking and voriconazole protocol in managing these cases warrants further investigation. Level of Evidence Level 4.https://doi.org/10.1002/lio2.70086chronic granulomatous invasive fungal sinusitischronic indolent granulomatous fungal sinusitisgranulomatous invasive fungal sinusitisparanasal sinus diseasesinusitis |
| spellingShingle | Abdulsalam Baqays Sarah Almutawa Razan Alsabti Luluh Alsughayer Sandra Campbell Nassr Almaflehi Hussain Albaharana Saad Alsaleh Systematic Review of Granulomatous Invasive Fungal Sinusitis Management Laryngoscope Investigative Otolaryngology chronic granulomatous invasive fungal sinusitis chronic indolent granulomatous fungal sinusitis granulomatous invasive fungal sinusitis paranasal sinus disease sinusitis |
| title | Systematic Review of Granulomatous Invasive Fungal Sinusitis Management |
| title_full | Systematic Review of Granulomatous Invasive Fungal Sinusitis Management |
| title_fullStr | Systematic Review of Granulomatous Invasive Fungal Sinusitis Management |
| title_full_unstemmed | Systematic Review of Granulomatous Invasive Fungal Sinusitis Management |
| title_short | Systematic Review of Granulomatous Invasive Fungal Sinusitis Management |
| title_sort | systematic review of granulomatous invasive fungal sinusitis management |
| topic | chronic granulomatous invasive fungal sinusitis chronic indolent granulomatous fungal sinusitis granulomatous invasive fungal sinusitis paranasal sinus disease sinusitis |
| url | https://doi.org/10.1002/lio2.70086 |
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