Author(s)
Peter K. Moon, MD
Yan Sun
Noel F. Ayoub, MD
Jayakar V. Nayak, MD, PhD
Zara M. Patel, MD
Peter H. Hwang, MD
Michael T. Chang, MD
Affiliation(s)
Stanford University
Abstract:
Introduction
There is limited understanding of sinonasal outcomes in patients treated for acute invasive fungal sinusitis (AIFS).
Methods
A single-institution, retrospective cohort study was conducted to characterise long-term sinonasal outcomes in treated AIFS patients. Patients who were surgically treated and had at least 1 follow-up visit were included. Between 2009-2025, 40 patients met criteria. Sinonasal outcomes were characterised by Lund-Kennedy (LK), SNOT-22, and SNOT-22 sub-domain (rhinologic, ear/facial, emotional, sleep) scores at clinic visits. Paired T-tests were used to compare scores between the earliest and latest visits. Linear mixed effects models assessed longitudinal associations between clinical and demographic factors, and LK and SNOT-22 scores.
Results
LK scores at the latest follow up visit were lower in comparison to the 1st follow up visit (1.79 ± 1.47 vs 4.08 ± 2.77; p<0.001). Total and subdomain SNOT-22 scores did not differ between earliest and latest visits. 5 patients (12.5%) met criteria for post-AIFS chronic rhinosinusitis. Linear mixed effects models showed that several factors, including laterality of surgery, insurance and race, were associated with greater LK scores. Development of post-treatment oroantral fistula was associated with higher total and several subdomain SNOT-22 scores, while hematologic malignancy was associated with lower total and several subdomain SNOT-22 scores.
Conclusion
Patients treated for AIFS demonstrated improvement in LK scores but not SNOT-22 scores over time. Surgical management of disease may fundamentally disrupt mucociliary function, thereby affecting sinonasal quality of life.