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KMID : 0390220000110020286
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Journal of Clinical Otolaryngology, Head and Neck Surgery
2000 Volume.11 No. 2 p.286 ~ p.292
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Clinical Analysis of Fungal Sinusitis
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Abstract
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Background and Objectives : In recent years there has been an increase in mycotic infections of the nose and
paranasal sinuses with frequent use of antibiotics, cytotoxic drugs, immuosuppressive therapy and increased
survival of chronically debilitated patients. Diagnosis of mycotic sinusitis has advanced markedly with availability
of computed tomomgraphy, magnetic resonance imaging and sinus endoscopy. The pathophyisology and clinical
features of mycotic sinusitis are different according to invasive and non-invasive forms. This study were
performed to evaluate 22 cases of mycotic sinusitis with their clinical presentation, course diagnostic and
treatment methods. Materials and Methods : Twenty-two cases of mycotic infections of the paranasal sinuses,
which were confirmed histopathologiclly, from June 1996 through December 1999 were evaluated retrospectively
depending on histopathology, clinical courses, diagnostic findings, and treatment results. Results : Of 22 cases
13 cases were non-invasive mycetoma and 11 cases were managed with endoscopic sinus surgery and 2 cases
with Caldwell-Luc's operation. Recurrences were not observed. Three cases with fulminant mycotic sinusitis
were treated necrotomy and systemic amphotericin B injection. Three cases thought to be allergic fungal
sinusitis showed positive allergic mucin and hyphae even though negative IgE-mediated atopy. Conclusion :
Mycotic sinusitis should always be considered in the differential diagnosis of chronic or recurring sinusitis
resistant to adequated medical treatment. Although definite diagnosis of mycotic sinusitis is based on
histopathologic examination of removed materials from sinus. CT and MRI are highly sensitive diagnostic tools
for evaluation this disease with diagnostic criteria.
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KEYWORD
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