Abstract: Objective This study aimed to explore the clinical characteristics of patients with invasive and non-invasive mucormycotic sinusitis. Methods We retrospectively analyzed 25 patients with mucormycotic sinusitis. The clinical characteristics, treatment methods, prognoses, and outcomes of the two groups of patients were analyzed. Results Non-invasive mucormycotic sinusitis mainly occurred unilaterally, with an average course of 6.83 months. The typical clinical manifestations were nasal congestion(13/21), purulent discharge(12/21), headache(11/21), and nasal odor(9/21). Most patients had no underlying diseases(15/21). CT revealed increased soft tissue density with calcification(16/21). All patients underwent endoscopic sinus surgery, during which cheese-like lumps were observed(17/21). No recurrence was observed during a follow-up of 6 months. Invasive mucormycotic sinusitis was primarily unilateral, with an average course of 25.75 days. The typical clinical manifestations included headache(4/4), eye pain(3/4), and vision loss(3/4), and all patients were diabetic(4/4). CT findings revealed changes in the sinus walls and surrounding bones(4/4). The patients underwent endoscopic sinus surgery combined with antifungal medication. Numerous fungal masses with purulent discharge(4/4), and bone destruction of the sinus and orbital walls(3/4)were observed intraoperatively. After a 2-year follow-up, there was no incidence of recurrence in two patients; however, mortality was reported in two patients. Conclusion Non-invasive mucormycotic sinusitis, uncommon in clinical practice, can be treated effectively with endoscopic sinus surgery. Adequate nasal and sinus drainage is the key tosuccessful treatment and a low postoperative recurrence rate. Invasive mucormycotic sinusitis progresses rapidly and has a high mortality rate, for which early surgery and antifungal drugs are critical.

Key words: Mucormycosis, Sinusitis, Invade, Endoscopic sinus surgery