Diagnosis

Radiologic examination with CT imaging frequently shows involvement of a single paranasal sinus with a mass lesion and thickening of the adjacent mucoperiosteum. Bone destruction and orbital involvement can be seen in advanced cases. Early endoscopic evaluation should be followed by biopsy of diseased mucosa and bone. Frozen section analysis revealing evidence of hyphae penetrating into the submucosa, vessels, or bone confirms the diagnosis. Aspiration of sinus contents and middle meatus cultures should be sent to microbiology for specific fungal stains and PCR analysis in an effort to identify the causative pathogen.

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