Fungus is present in all our surroundings and the air we inhale through the nose. It may be more prevalent in certain moist and humid environments. Most healthy people do not react to the presence of fungus inhaled through their noses on a daily basis, due to a normal functioning immune system. However, in very rare instances, fungus may cause acute or chronic inflammation in the nose and the sinuses.

Fungal sinusitis can come in many forms. It is broadly classified into invasive and non-invasive types:

• Noninvasive: These types are generally non-life threatening and often times associated with certain environmental allergies. It is associated with chronic sinusitis.
• Invasive: These types can progress rapidly and may be life-threatening, requiring hospital admission and further testing and treatments. These invasive infections are generally found in patients with uncontrolled diabetes, or patients undergoing chemotherapy for a variety of blood-related tumors (such as leukemia or lymphoma).

The symptoms of sinusitis may include:

• General fatigue
• Loss of smell or taste
• Nasal congestion or obstruction
• Pain or pressure in face and sinuses
• Runny nose with discolored thick drainage

Tests

Nasal Endoscopy
Your ENT doctor inserts a thin, flexible or rigid endoscope with a tiny camera attached to a high definition monitor, to visually inspect the inside of the sinuses to help determine the extent of the fungal sinusitis. This test is more likely to be used in the case of chronic sinusitis.

Imaging
Images obtained from computerized tomography (CT) scan or magnetic resonance imaging (MRI) can help your doctor see details of your sinuses and nasal passages, and determine how much the fungus has spread through your sinuses.

Nasal and Sinus Cultures
When your fungal sinusitis is long-lasting and does not respond to treatment, your ENT specialist may recommend taking a culture (mucous or tissue sample) from the nasal area or sinuses, to further assess the exact microbe (fungus or bacterial) contributing to your sinusitis and nasal inflammation.

Allergy Testing
If your ENT specialist thinks that allergies may be contributing to your chronic sinusitis, he or she may order an allergy skin test or consult with an allergist. This test may help determine the allergen that’s causing inflammation and exacerbating the chronic sinusitis.

Treatments

Medications
If the infection is non-life threatening and the fungus is non-invasive, your ENT doctor may recommend medication, such as oral steroids or antifungal medications, to reduce inflammation. However, if you have invasive fungal sinusitis, our surgeons are ready for immediate intervention, including endoscopic sinus surgery, to remove tissue affected by the fungus.

Nasal Sprays
Nasal decongestant sprays can be used to treat nasal stuffiness. They should not be used longer than three days. With long-term use of nasal decongestant sprays, the nose can become dependent on them, enlarging the turbinates, and causing nasal stuffiness can worsen, requiring turbinate surgery.

Nasal/Sinus Irrigation
Your ENT specialist may recommend a nasal/sinus irrigation for your fungal sinusitis, particularly if you have had previous surgery. Sometimes topical antifungal or antibiotics (if there are associated bacterial infections) may be added to the irrigations.

Surgery
With recent advances in technology, ENT surgeons can now perform endoscopic sinus surgery entirely through the nose, without face or mouth incisions. When minimally invasive surgery is not an option, the ENT surgeon may need to perform sinus surgery via an external approach. The goal of surgery is to remove all the fungus-infected mucus and tissues, to allow the sinuses to heal, and to allow topical (on the skin) therapies.

Why Choose UHealth?

Ranked No. 28 in the nation according to U.S. News & World Report. The ranking reflects the team’s dedication to excellence in research patient care and outcomes. Surgeons, audiologists, biomedical engineers, speech pathologists, researchers, and psychologists collaborate with many research programs at the University of Miami Miller School of Medicine to deliver the best possible multidisciplinary care to pediatric and adult ear, nose, and throat patients.

Highly specialized rhinology doctors. The experts at University of Miami Health are here to help you breathe easier, smell better, and rest better with an accurate diagnosis and leading edge treatments in a compassionate setting. Our fellowship-trained providers specialize in the nasal airway, and our rhinology specialists have completed specialized training in nasal and sinus disorders. They have dedicated their clinical and research careers to caring for nasal and sinus disorders.

Our academic health center provides you with more treatment options. Our ENT specialists are experts in the field of rhinology. As part of an academic health center, we are proud to offer breakthrough treatments not available to other facilities in South Florida. We also offer our patients early access to clinical trials and new medical and procedural treatments. We provide comprehensive care for a wide array of rhinologic conditions, backed by expertise, research, and education.