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Clinical features of chronic fungal rhinosinusitis in Korean geriatric and non-geriatric patients

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Worldwide, the incidence of chronic fungal rhinosinusitis (CFRS) has increased. Although ageing leads to weakening of the immune system, which increases susceptibility to CFRS, the CFRS characteristics in geriatric patients are unclear. Therefore, we comparatively analysed the clinical characteristics of CFRS in geriatric and non-geriatric patients.

Methods

This retrospective analysis compared the demographics, rhinologic symptoms, multiple allergen simultaneous tests, olfactory function tests, paranasal sinus computed tomography findings, and outcomes of 131 patients with CFRS who underwent functional endoscopic sinus surgery and 131 enrolled patients were divided in geriatric (> 65 years) and non-geriatric (≤ 65 years) groups.

Results

Among the geriatric and non-geriatric participants (n = 65, 49.6% and n = 66, 50.4%, respectively), hypertension and diabetes mellitus were more common in the geriatric group. Demographics, including symptoms, showed no significant intergroup differences. Normosmia and hyposmia were significantly less prevalent, whereas phantosmia and parosmia were more prevalent in the geriatric group than in the non-geriatric group (p = 0.03 and p = 0.01, respectively). Sphenoidal sinus involvement was significantly higher in geriatric patients than in non-geriatric patients (p = 0.02).

Conclusion

Based on greater sphenoidal sinus involvement, a deeper anatomical area is more vulnerable to fungal infection in the geriatric group than in the non-geriatric group. Increasing clinicians’ awareness of CFRS in geriatric patients with olfactory dysfunction, including phantosmia and parosmia, is important for early intervention.

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Data availability

Not applicable.

Code availability

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Abbreviations

HTN:

Hypertension

DM:

Diabetes mellitus

AID:

Autoimmune disease

MAST:

Multiple allergen simultaneous test

KVSS:

Korean version of the Sniffin’ sticks test

CRS:

Chronic rhinosinusitis

CFRS:

Chronic fungal rhinosinusitis

EPOS 2020:

European position paper on rhinosinusitis and nasal polyps 2020

PNS-CT:

Paranasal sinus computed tomography

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Funding

This work was supported by a faculty research grant from Wonju College of Medicine, Yonsei University [Grant no. 2022-52-0054 to E.J.L.] and by the Basic Science Research Program of the National Research Foundation of Korea (NRF), which is funded by the Ministry of Science and ICT, Republic of Korea [grant no. NRF-2021R1A2C1010082 to E.J.L.].

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan-Ro, Wonju, Gangwon-Do, Republic of Korea

    Cheol Hyo Ku, Ha Neul Lee, Sang Man Park, Hyun Su Lee, Jae Woo Lee, Dong-Joon Park & Eun Jung Lee

  2. Department of Biostatistics, Yonsei University Wonju College of Medicine, Wonju, South Korea

    Se Hwa Hong

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  1. Cheol Hyo Ku
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Contributions

EJL and SMP designed the study, managed data extraction, and interpreted the data. SHH and JWL performed the statistical analyses. CHK, HNL, and EJL prepared the manuscript. CHK and HNL formatted the manuscript. EJL, SMP, HSL, D-JP, and CHK interpreted data and reviewed the manuscript. EJL initiated and supervised this study. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Eun Jung Lee.

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Competing interest

The authors declare no competing interests.

Ethical approval

This study was approved by the Institutional Review Board of the Wonju Severance Christian Hospital, Wonju, Republic of Korea (IRB No. CR321077), in accordance with the Declaration of Helsinki.

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Ku, C.H., Lee, H.N., Park, S.M. et al. Clinical features of chronic fungal rhinosinusitis in Korean geriatric and non-geriatric patients. Eur Arch Otorhinolaryngol 280, 4969–4977 (2023). https://doi.org/10.1007/s00405-023-08089-4

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