THỰC TRẠNG VIÊM MŨI XOANG DO NẤM TẠI BỆNH VIỆN TAI MŨI HỌNG TRUNG ƯƠNG NĂM 2023 – 2024

Abstract

Objectives: this study aims to describe the clinical and paraclinical characteristics of patients diagnosed with fungal rhinosinusitis. Subjects and methods: this descriptive case series study included 86 patients diagnosed with chronic fungal rhinosinusitis who underwent endoscopic sinus surgery at the National Otorhinolaryngology Hospital of Vietnam between September 2023 and June 2024. Results: the most common clinical symptoms were nasal discharge (62.8%), unilateral nasal obstruction (46.5%), cephalon-facial pain (33.7%), hyposmia (10.5%), and purulent foul-smelling nasal discharge (24.4%). Endoscopic findings revealed mucopurulent discharge from the middle meatus on one side in 83.7% of patients, mucopus in the sphenoethmoidal recess in 10.5%, edematous mucosa in 75.6%, and suspected fungal masses in the middle meatus or nasal cavity in 14.0%. Computed tomography images showed calcification or increased density within the sinuses (83.7%), sinus wall thickening (72.1%), and bony destruction (2.3%). The most common fungal species identified were Aspergillus (95.3%), followed by Candida (3.5%) and Curvularia (1.2%). Histopathological examination of sinus tissues revealed chronic inflammation (81.4%), polypoid degeneration (15.1%), and fungal invasion of the mucosa and blood vessels (2.3%). Conclusion: chronic fungal rhinosinusitis in the National Otorhinolaryngology Hospital of Vietnam is mainly caused by Aspergillus, while nasal discharge and obstruction are common clinical presentations, the integration of both characteristic endoscopic findings, computed tomography imaging and histopathological examination after underwent endoscopic sinus surgery plays a crucial role in accurate diagnosis and guiding appropriate treatment strategies.