Invasive Fungal Sinusitis of the Sphenoid Sinus.
- Author:
Dong Hoon LEE
1
;
Tae Mi YOON
;
Joon Kyoo LEE
;
Young Eun JOO
;
Kyung Hwa PARK
;
Sang Chul LIM
Author Information
- Publication Type:Original Article
- Keywords: Invasive; Fungus; Sinusitis; Sphenoid sinus
- MeSH: Aneurysm; Carotid Artery, Internal; Debridement; Diabetes Mellitus; Early Diagnosis; Fungi; Humans; Mortality; Prognosis; Retrospective Studies; Rupture; Sinusitis*; Sphenoid Sinus*; Survival Rate
- From:Clinical and Experimental Otorhinolaryngology 2014;7(3):181-187
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: This study was conducted to present the clinical outcome of invasive fungal sinusitis of the sphenoid sinus and to analyze clinical factors influencing patient survival. METHODS: A retrospective review of 12 cases of invasive fungal sphenoiditis was conducted. RESULTS: Cases were divided into acute fulminant invasive fungal spheonoidits (n=4) and chronic invasive fungal sphenoiditis (n=8). The most common underlying disease was diabetes mellitus (n=9). The most common presenting symptoms and signs included visual disturbance (100%). Intracranial extension was observed in 8 patients. Endoscopic debridement and intravenous antifungals were given to all patients. Fatal aneurysmal rupture of the internal carotid artery occurred suddenly in two patients. The mortality rate was 100% for patients with acute fulminant invasive fungal sphenoiditis and 25% for patients with chronic invasive fungal sphenoiditis. In survival analysis, intracranial extension was evaluated as a statistically significant factor (P=0.027). CONCLUSION: The survival rate of chronic invasive fungal sphenoiditis was 75%. However, the prognosis of acute fulminant invasive fungal sphenoiditis was extremely poor despite the application of aggressive treatment, thus, a high index of suspicion should be required and new diagnostic markers need to be developed for early diagnosis of invasive fungal sinusitis of the sphenoid sinus.
