Objectives: Fungal infections have recently emerged as an important cause of acute and chronic rhinosinusitis, and account for 6–12% of cases. The main aim of the study was to study the histopathological spectrum of fungal rhinosinusitis (FRS) in western India. Materials and Methods: All histologically proven cases of acute and chronic rhinosinusitis from January 2015 to December 2020 were reviewed. Relevant clinical details and microbiological culture reports were collected. The histological slides were reviewed with routine hematoxylin and eosin stain, periodic acid–Schiff, and Gomori’s methenamine silver stains. Statistical analysis: Data were summarized using Microsoft Excel 2020. Means and standard deviations were computed using the same method. Results: Of 873 cases of acute and chronic rhinosinusitis, 10.3% (90/873) were of fungal etiology. The mean age of patients was 39 years with male: female ratio of 1.5:1. The histopathological examination categorized FRS into allergic FRS (AFRS) in 39 (43.3%), fungal ball in 8.9%, acute invasive FRS in 33.3%, chronic invasive granulomatous FRS in 10%, chronic invasive FRS in 2.2%, and mixed pattern in 2.2% cases. Comorbidities were present in 30 cases, with diabetes being the most common. Culture reports were available in 40 cases and yielded positive results in 16 cases. Conclusions: All subtypes of FRS are identified in Western Rajasthan, with AFRS as the commonest. FRS should always be considered when interpreting any paranasal sinus biopsies or resections. Understanding histopathological characteristics is essential for accurate sub-classification and suitable treatment.
Vishwajeet et al. (Sat,) studied this question.