Özet:

The aim of this study was to investigate the role of bacterial and especially fungal infections in the etiology of the chronic sinusitis in patients treated by functional endoscopic sinus surgery (FESS). Thirtythree adult patients (20 males, 13 females), underwent FESS, were included into the study. All patients were evaluated with a questionnaire form and ENT examination. In all cases, a routine nasal endoscopy with 0° and 30° endoscopes; Waters’ graphy; axial and coronal Computed Tomographic (CT) scans of paranasal sinuses were performed. Specimens obtained during FESS were evaluated by bacterial and fungal cultures; microbiological and histopathological examinations. There was focal hyperintensity in CT of one patient. In the result of aerobic cultures, coagulase-negative staphylococci were grown in 22 of the 33 specimens (66.6%). In one case (3%), corynebacterium species were isolated; and in others, no growth was detected. In fungal cultures, no fungi were found although all cultures were incubated for seven-day time. Pathologic examination revealed septated hyphae and darkly pigmented fruiting heads characteristic of Aspergillus niger in two cases (6%).They were in fungus ball form in maxillary sinus. No mycotic infiltration was observed in the sinus mucosa. Prevalance of fungal agents in the etiology of chronic sinusitis depends on climate and host factors. If there especially are mass and chronic sinusitis symptoms in paranasal sinus CT, mycotic etiology should be kept in mind in the differential diagnosis. Aspergillus niger may be one of the fungal agents causing mycotic sinusitis.

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