RT Journal Article
T1 Comprehensive management of paranasal sinus fungus balls: A Young-IFOS consensus statement.
A1 Saibene, Alberto Maria
A1 Allevi, Fabiana
A1 Calvo-Henriquez, Christian
A1 Dauby, Nicolas
A1 Dondossola, Daniele
A1 Hervochon, Rémi
A1 Lechien, Jérome R
A1 Lobo-Duro, David
A1 Locatello, Luca Giovanni
A1 Maniaci, Antonino
A1 Mannelli, Giuditta
A1 Mayo-Yáñez, Miguel
A1 Maza-Solano, Juan
A1 Radulesco, Thomas
A1 Tan, Neil
A1 Tincati, Camilla
A1 Tucciarone, Manuel
A1 Vaira, Luigi Angelo
A1 Sowerby, Leigh
K1 antibiotics
K1 computed tomography
K1 endoscopy
K1 guideline
K1 maxillary sinus
K1 mycosis
AB Paranasal sinus fungus balls (PSFB) are a common form of surgically treatable, noninvasive mycosis. To date, no guidelines have standardized PSFB treatment or management of difficult cases (eg, immunocompromised or fragile patients). The clinical consensus statement presented herein aims to provide a comprehensive management guide to PSFB based on current evidence. A multidisciplinary, international panel of 19 specialists judged statements in 3 rounds of a modified Delphi method survey. Statements encompassed the following PSFB management issues: definition, diagnostic workup; treatment indications and modalities; and follow-up. Otolaryngologists, maxillofacial surgeons, infectious disease specialists, and transplant physicians were considered the target audience. Among the 23 statements, 7 reached strong consensus and 16 reached consensus. Consensus was reached on the definition, diagnosis, and treatment modalities for PSFB. Postoperative follow-up modalities and scenarios with bacterial superinfection were the most debated issues. Until further data are available, these points provide a framework for the management of PSFB. Moreover, PSFB should be considered a noninvasive mycosis that is not necessarily symptomatic or related to odontogenic conditions. Although diagnosis may be incidental, endoscopy and single imaging (computed tomography or magnetic resonance imaging, with distinctive features) are required for diagnosis, whereas contrast medium would allow for differential diagnosis. Although treatment of PSFB should be considered mandatory before sinus augmentation and is recommended for symptomatic patients, immunosuppressed patients, or patients with planned immunosuppression, watchful waiting could be considered for asymptomatic patients with chronic rhinosinusitis who are provided with appropriate advice and assessment.
YR 2022
FD 2022-09-23
LK http://hdl.handle.net/10668/20063
UL http://hdl.handle.net/10668/20063
LA en
DS RISalud
RD Apr 10, 2025