Fungal Sinusitis

As noted by ENT Tulsa Dr. Scott Cordray, there are several different types of fungal sinusitis. Some types are more prone to cause nasal polyps while others can be life-threatening and cause invasion into the brain or eye. Fungal sinusitis usually presents with all the same symptoms as other types of sinusitis such as pressure and/or pain over the sinuses or face, decreased smell.  Nasal congestion is the most common.

Some people will feel pain in-between or behind their eyes. Typically, this is treated with nasal steroids and antibiotics. However, when this is ongoing for more than 12 weeks, it is considered chronic and warrants further investigation with an X-ray, computerized tomography (CT or the old term CAT scan). Most of the time fungal sinusitis can be seen on CT with certain characteristics. ENT Tulsa Dr. Scott Cordray provides the CT scan in the convenience of his office.

There are multiple causes of fungal sinusitis. Basically, anything that lowers your immune system can contribute to fungal sinusitis. Another potential cause is the overuse of antibiotics. The antibiotics will kill the offending bacteria but also can kill the bacteria that keeps the fungus in check. A more uncommon cause of fungal sinusitis would be the inhalation of contaminated street drugs.

ENT Tulsa Dr. Scott Cordray has noted the body can have an enormous allergy reaction to the fungus which can cause the mucosa in the nose (skin lining the inside of the nose) to swell. After hundreds of exaggerated events like this, the mucosal will swell so much that it forms polyps. The polyps / swollen mucosa then blocks the sinus drainage pathway. This causes mucous to be trapped in a warm dark and moist environment which is a set up for more infection.

Once this occurs, the polyps will need to be removed as well as all the fungus. This is a simple safe surgical procedure that can be performed in the office of ENT Tulsa Dr. Scott Cordray’s Ears, Nose and Throat, Inc. in most circumstances. The follow up care and treatment is as important as removing the fungus and opening the sinuses. Once the sinuses are open, they can then begin to drain the mucous, air can enter the sinuses to restore their normal healthy state.

Fungus and polyps almost always try to regrow. ENT Tulsa Dr. Scott Cordray uses antifungal nasal rinses and oral steroids to mitigate or decrease the chance the fungus will return, and polyps regrow. This can be a long process which may require months to years of follow up to keep the polyps and fungus at bay. Most of the time it will take physical exam to see the polyps but also requires follow up CT X-Rays to catch the disease earlier in the recurrent process.

Many times, the fungus comes back but you cannot see it on a normal exam even with an endoscope. You can see the process very early if you follow this process with a CT as it can hide inside the sinuses where the doctor cannot see. Having a CT in ENT Tulsa expert Dr. Scott Cordray’s office gives only one third of the radiation which allows us to follow this process much more closely at no additional risks. This allows our patients to get 3 to 4 CT X-Rays with no more radiation or risks than you can get with one CT at the hospital or outpatient facility. Most of the time, Dr. Cordray is able to catch this process early and prevent many from having to have their polyps and fungus removed over and over via surgical procedures.

Dr. Cordray, as one of the top ENT Tulsa experts, offers  dissolvable stents to place into the sinus openings after he has surgically opened them. The stents are impregnated with an anti-polyp medicine to keep them from growing back. The stents are also spring loaded and help mechanically hold open the sinuses while they are healing. They will dissolve in about 30 days. Sometimes Dr. Cordray takes them out, however, other times they will come out on their own. When they come out on their own, it looks like pieces of old monofilament fishing line.

If you or someone you know suffers from any of the symptoms above, ENT Tulsa’s Dr. Cordray strongly encourages you (or them) to come in for an evaluation to see if you can improve a much better quality of life.