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Non-allergic fungal sinusitis: In some instances, mucin and fungus may be identified in patients with sinusitis in the absence of any allergy to fungus.Acute Invasive Fungal Sinusitis: This is the most dangerous and life-threatening form of fungal sinusitis. Chronic invasive fungal sinus: Unlike acute invasive fungal sinusitis whose typical course is less than 4 weeks (and can actually progress over hours and days), chronic invasive fungal sinusitis is a slower destructive process. Granulomatous invasive fungal sinusitis: This form of fungal sinusitis is rare in the United States.
A complete evaluation by your rhinologist will help to determine if you have a form of fungal sinusitis and how it needs to be treated, as some forms of fungal sinusitis have distinctly different medical and surgical treatments.

Whether these fungi are innocent bystanders or are the cause of sinus disease is currently under investigation and a subject of great debate. The most commonly involved sinuses are the maxillary and the sphenoid sinuses, where the fungus finds favorable conditions such as warmth and humidity for growth.
Sometimes, bacteria can cause super-added infection in the sinus affected by the fungus ball. Typically, only a single sinus is involved, and the disease has a classic appearance on CT or MRI scans. Most patients have excellent results from surgery, and may not require any further treatment.

Treatment involves endoscopic sinus surgery to clear polyps and allergic mucin, and to restore the ventilation and drainage of sinuses. Patients may also benefit from treatment of allergy with immunotherapy (allergy shots or drops) and antihistamines. Anti-fungal treatment is usually not required, as it is the reaction to the fungus that needs to be modulated.

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