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KMID : 1195620140070030181
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Clinical and Experimental Otorhinolaryngology
2014 Volume.7 No. 3 p.181 ~ p.187
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Invasive Fungal Sinusitis of the Sphenoid Sinus
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Lee Dong-Hoon
Yoon Tae-Mi
Lee Joon-Kyoo
Joo Young-Eun
Park Kyung-Hwa
Lim Sang-Chul
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Abstract
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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.
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KEYWORD
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Invasive, Fungus, Sinusitis, Sphenoid sinus
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