الفهرس 
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Abstract
The first case of fungal sinusitis was reported in 1885. This fungal disease occurred rarely until the past decade, when a worldwide increase in its incidence occurred. Till one decade back bacteria was implicated as pathogen in most form of chronic rhinosinusitis (CRS). Fungi were thought to be responsible for few specific forms, sine 1999, when ponikau and associates claimed that fungi were responsible for nearly all cases of CRS. Their study demonstrated the presence of fungi & eosinophils from nose & paranasal sinuses from ~96 % cases of CRS.
There is a growing body of evidence suggesting that fungal biofilm colonization of host surfaces may be an important factor in chronic disease in the absence of foreign bodies, and fungal biofilms have been discovered on the sinonasal mucosa of CRS patients.
Fungal biofilms are poorly understood compared with their bacterial counterparts and represent an expanding area of research, both within otorhinolaryngology and the wider microbiological community, as the further the understanding of bacterial and fungal biofilms, so too the understanding of the etiopathogenesis of CRS will improve.
To our knowledge and to date search medical articles and websites, this study is the first to concentrate on detection of fungal biofilm in different types of fungal sinusitis whether primary or recurrent, also whether invasive or non-invasive.
The aim of this study was to detect the presence of fungal biofilm, in patients with fungal sinusitis trying to find its role in recurrence of fungal sinus infection, resistance to medical treatment and occurrence of intra orbital and intracranial complications.
The study consisted of 20 different cases of fungal sinusitis controlled by 10 cases of non fungal sinusitis. Control cases were divided into 5 cases of chronic sinusitis with nasal polyposis and 5 cases of deviated septum with no evidence of sinusitis undergoing nasal surgery.
Cases of fungal sinusitis were divided into primary and recurrent cases, also into invasive and non invasive cases.
Using statistical analysis, there was evidence of pressure of fungal biofilm in different cases of fungal sinusitis whether primary or recurrent, also whether invasive or non invasive.
The study showed the presence of fungal biofilm in different cases of fungal siunsitis whether primary or recurrent, also whether invasive or non invasive.
We finally recommend more research in area of fungal biofilm as it is poorly studied compared to bacterial biofilm, the use of more advanced confocal laser microscopy for optimal detection of biofilm and more research to discover efficacious treatment options to eradicate sinonasal biofilms to improve the outcomes of our most recalcitrant patients.