{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T23:57:50Z","timestamp":1778630270729,"version":"3.51.4"},"reference-count":17,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T00:00:00Z","timestamp":1664928000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Paranasal sinus fungus balls (PSFB) are a common form of surgically treatable, noninvasive mycosis. To date, no guidelines have standardized PSFB treatment or management of difficult cases (eg, immunocompromised or fragile patients). The clinical consensus statement presented herein aims to provide a comprehensive management guide to PSFB based on current evidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A multidisciplinary, international panel of 19 specialists judged statements in 3\u00a0rounds of a modified Delphi method survey. Statements encompassed the following PSFB management issues: definition, diagnostic workup; treatment indications and modalities; and follow\u2010up. Otolaryngologists, maxillofacial surgeons, infectious disease specialists, and transplant physicians were considered the target audience.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 23 statements, 7 reached strong consensus and 16 reached consensus. Consensus was reached on the definition, diagnosis, and treatment modalities for PSFB. Postoperative follow\u2010up modalities and scenarios with bacterial superinfection were the most debated issues.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Until further data are available, these points provide a framework for the management of PSFB. Moreover, PSFB should be considered a noninvasive mycosis that is not necessarily symptomatic or related to odontogenic conditions. Although diagnosis may be incidental, endoscopy and single imaging (computed tomography or magnetic resonance imaging, with distinctive features) are required for diagnosis, whereas contrast medium would allow for differential diagnosis. Although treatment of PSFB should be considered mandatory before sinus augmentation and is recommended for symptomatic patients, immunosuppressed patients, or patients with planned immunosuppression, watchful waiting could be considered for asymptomatic patients with chronic rhinosinusitis who are provided with appropriate advice and assessment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.23093","type":"journal-article","created":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T19:43:22Z","timestamp":1663962202000},"page":"877-885","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Comprehensive management of paranasal sinus fungus balls: A Young\u2010IFOS consensus statement"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1457-6871","authenticated-orcid":false,"given":"Alberto Maria","family":"Saibene","sequence":"first","affiliation":[{"name":"Young Otolaryngologists\u2013International Federation of Otorhinolaryngological Societies  Paris France"},{"name":"Otolaryngology Unit, ASST Santi Paolo E Carlo, Department of Health Sciences Universit\u00e0 Degli Studi Di Milano  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5012-4031","authenticated-orcid":false,"given":"Fabiana","family":"Allevi","sequence":"additional","affiliation":[{"name":"Young Otolaryngologists\u2013International Federation of Otorhinolaryngological Societies  Paris France"},{"name":"Maxillofacial Surgery Unit, ASST Santi Paolo E. Carlo, Department of Health Sciences Universit\u00e0 Degli Studi Di Milano  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3580-0967","authenticated-orcid":false,"given":"Christian","family":"Calvo\u2010Henriquez","sequence":"additional","affiliation":[{"name":"Young Otolaryngologists\u2013International Federation of Otorhinolaryngological Societies  Paris France"},{"name":"Otolaryngology, Rhinology and Sleep Apnea Unit Hospital Complex of Santiago de Compostela  Santiago de Compostela Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7697-6849","authenticated-orcid":false,"given":"Nicolas","family":"Dauby","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, CHU Saint\u2010Pierre, Universit\u00e9 Libre de Bruxelles, School of Public Health Universit\u00e9 Libre de Bruxelles &amp; Institute for Medical Immunology  Brussels Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniele","family":"Dondossola","sequence":"additional","affiliation":[{"name":"Department of General and Liver Transplant Surgery Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1569-3578","authenticated-orcid":false,"given":"R\u00e9mi","family":"Hervochon","sequence":"additional","affiliation":[{"name":"Young Otolaryngologists\u2013International Federation of Otorhinolaryngological Societies  Paris France"},{"name":"ENT Department Piti\u00e9 Salp\u00eatri\u00e8re Hospital  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00e9rome R.","family":"Lechien","sequence":"additional","affiliation":[{"name":"Young Otolaryngologists\u2013International Federation of Otorhinolaryngological Societies  Paris France"},{"name":"Department of Head and Neck Surgery Foch Hospital, Paris Saclay University  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4322-6638","authenticated-orcid":false,"given":"David","family":"Lobo\u2010Duro","sequence":"additional","affiliation":[{"name":"Young Otolaryngologists\u2013International Federation of Otorhinolaryngological Societies  Paris France"},{"name":"Rhinology, Endoscopic Sinus &amp; Skull Base Surgery Hospital Universitario Marqu\u00e9s de Valdecilla  Santander Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1879-5580","authenticated-orcid":false,"given":"Luca Giovanni","family":"Locatello","sequence":"additional","affiliation":[{"name":"Young Otolaryngologists\u2013International Federation of Otorhinolaryngological Societies  Paris France"},{"name":"Department of Otorhinolaryngology, Sant'Antonio Abate Hospital Azienda Sanitaria Universitaria Friuli Centrale  Tolmezzo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonino","family":"Maniaci","sequence":"additional","affiliation":[{"name":"Young Otolaryngologists\u2013International Federation of Otorhinolaryngological Societies  Paris France"},{"name":"Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia University of Catania  Catania Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuditta","family":"Mannelli","sequence":"additional","affiliation":[{"name":"Young Otolaryngologists\u2013International Federation of Otorhinolaryngological Societies  Paris France"},{"name":"Department of Experimental and Clinical Medicine University of Florence  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1829-6597","authenticated-orcid":false,"given":"Miguel","family":"Mayo\u2010Y\u00e1\u00f1ez","sequence":"additional","affiliation":[{"name":"Young Otolaryngologists\u2013International Federation of Otorhinolaryngological Societies  Paris France"},{"name":"Otorhinolaryngology\u2010Head and Neck Surgery Department Complexo Hospitalario Universitario A Coru\u00f1a  A Coru\u00f1a Galicia Spain"},{"name":"Clinical Research in Medicine, International Center for Doctorate and Advanced Studies Universidade de Santiago de Compostela  Santiago de Compostela Galicia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Maza\u2010Solano","sequence":"additional","affiliation":[{"name":"Young Otolaryngologists\u2013International Federation of Otorhinolaryngological Societies  Paris France"},{"name":"Rhinology &amp; 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