Objective: To evaluate the effects of different surgical procedures on allergic fungal sinusitis. Methods: Thirty-one patients with allergic fungal sinusitis under endoscopic sinus surgery(24 cases) and Caldwell-Luc o...Objective: To evaluate the effects of different surgical procedures on allergic fungal sinusitis. Methods: Thirty-one patients with allergic fungal sinusitis under endoscopic sinus surgery(24 cases) and Caldwell-Luc operation(7 cases) after medical treatment were investigated. Results: No complication was observed during one year's follow-up. No patient who conducted endoscopic sinus surgery reacurred and 3 patients who received traditional surgery required a second operation. Conclusion: This confirmed endoscopic sinus surgery provided a mini-traumatic and effective treatment. Combined treatment of surgical and medical ways was useful to the development of allergic fungal sinusitis.展开更多
Clinical experience has suggested the existence of an intermediate form of fungal sinusitis between the categories of non-invasive fungal sinusitis (non-IFS) and invasive fungal sinusitis (IFS).This fungal sinusitis v...Clinical experience has suggested the existence of an intermediate form of fungal sinusitis between the categories of non-invasive fungal sinusitis (non-IFS) and invasive fungal sinusitis (IFS).This fungal sinusitis variant demonstrates unhealthy mucosa by endoscopy with fungal invasion,but lacks angioinvasion microscopically,representing what clinically behaves as a ‘pre-invasive’ subtype of fungal sinusitis.Unlike non-IFS disease,patients with preinvasive fungal sinusitis were still felt to require anti-fungal medications due to histologic presence of invasive fungus.While sharing some clinical features of IFS,these ‘intermediate’ patients were successfully spared extended and repeated surgical debridements given the microscopic findings,and have been successfully treated with shorter courses of antifungal therapy.These select patients have had favorable outcomes when managed in a judicious and semi-aggressive manner,in an undefined zone between the treatments for routine fungal ball and aggressive IFS.展开更多
Studying the pathophysiology of allergic fungal rhinosinusitis (AFRS) has proved challenging. While this clinical entity is easily distinguishable based on the clinical criteria set forth by Bent and Kuhn twenty-five ...Studying the pathophysiology of allergic fungal rhinosinusitis (AFRS) has proved challenging. While this clinical entity is easily distinguishable based on the clinical criteria set forth by Bent and Kuhn twenty-five years ago, studies examining type 2 inflammatory profiles in AFRS can make it seem more alike other CRS subtypes than it is different. Still, evolving research seems to clearly delineate this subtype from others in CRS. This review will critically evaluate the evolution of research examining the pathophysiology of AFRS and will conclude with a summary of the special considerations in the management of this fascinating disease.展开更多
Mucormycosis is caused by the fungi belonging to the order Mucorales and class Zygomycetes.The incidence of mucormycosis has increased with the onset of the severe acute respiratory syndrome coronavirus 2 infections l...Mucormycosis is caused by the fungi belonging to the order Mucorales and class Zygomycetes.The incidence of mucormycosis has increased with the onset of the severe acute respiratory syndrome coronavirus 2 infections leading to the coronavirus disease 2019(COVID-19)pandemic.This rise is attributed to the use of immunosuppressive medication to treat COVID-19 infections.Authors have retrospectively collected data of our cases of mucormycosis diagnosed from April 2020 to April 2021 at our institute.A total of 20 patients with rhinocerebral mucormycosis were studied.Most of the study subjects were male patients(90%)and were of the age group 41-50 years.Most patients in the review had comorbidities(85%)with diabetes being the most common comorbidity.Para nasal sinuses were involved in all the cases.Involvement of the neck spaces was present in 60%of the cases.Involvement of the central nervous system was present in 80%of the cases.Orbital involvement was present in 90%of the cases.The authors reviewed the various imaging findings of mucormycosis on computed tomography and magnetic resonance imaging in this article.展开更多
Background:Invasive sphenoid sinus aspergillosis is a rare but life-threatening condition usually found in immunocompromised patients.When involving cavernous sinus and surrounding structures,patients are frequently m...Background:Invasive sphenoid sinus aspergillosis is a rare but life-threatening condition usually found in immunocompromised patients.When involving cavernous sinus and surrounding structures,patients are frequently misdiagnosed with a neoplasm or sellar abscess.Timely diagnosis and intervention are crucial to patients’outcomes.The objective of this study is to review cases of invasive sphenoid sinus aspergillosis to describe disease manifestations,imaging features,treatment,and outcome.Case presentation:We describe four patients with invasive sphenoid sinus aspergillosis misdiagnosed as sellar tumors preoperatively.The mass was completely removed in three patients and partially removed in one patient microscopically.Pathological examinations confirmed Aspergillus in all cases.All four patients received anti-fungal agents postoperatively.There was no recurrence at the time of each patient’s follow-up date.One patient with complete resection was lost to follow-up while the other three patients’neurologic function improved.Additionally,we performed a systematic review regarding invasive sphenoid sinus aspergillosis of existing English literature.Conclusion:With regard to clinical symptoms,headache,vision impairment,and ophthalmoplegia were observed in over half of the patients in the literature.A sellar mass with bone destruction on CT and involvement of cavernous sinus is highly suggestive of invasive fungal sphenoid sinusitis.Immediate surgical removal of the lesion is recommended for invasive sphenoid sinus aspergillosis to preserve nerve function and increase the likelihood of survival.展开更多
文摘Objective: To evaluate the effects of different surgical procedures on allergic fungal sinusitis. Methods: Thirty-one patients with allergic fungal sinusitis under endoscopic sinus surgery(24 cases) and Caldwell-Luc operation(7 cases) after medical treatment were investigated. Results: No complication was observed during one year's follow-up. No patient who conducted endoscopic sinus surgery reacurred and 3 patients who received traditional surgery required a second operation. Conclusion: This confirmed endoscopic sinus surgery provided a mini-traumatic and effective treatment. Combined treatment of surgical and medical ways was useful to the development of allergic fungal sinusitis.
文摘Clinical experience has suggested the existence of an intermediate form of fungal sinusitis between the categories of non-invasive fungal sinusitis (non-IFS) and invasive fungal sinusitis (IFS).This fungal sinusitis variant demonstrates unhealthy mucosa by endoscopy with fungal invasion,but lacks angioinvasion microscopically,representing what clinically behaves as a ‘pre-invasive’ subtype of fungal sinusitis.Unlike non-IFS disease,patients with preinvasive fungal sinusitis were still felt to require anti-fungal medications due to histologic presence of invasive fungus.While sharing some clinical features of IFS,these ‘intermediate’ patients were successfully spared extended and repeated surgical debridements given the microscopic findings,and have been successfully treated with shorter courses of antifungal therapy.These select patients have had favorable outcomes when managed in a judicious and semi-aggressive manner,in an undefined zone between the treatments for routine fungal ball and aggressive IFS.
文摘Studying the pathophysiology of allergic fungal rhinosinusitis (AFRS) has proved challenging. While this clinical entity is easily distinguishable based on the clinical criteria set forth by Bent and Kuhn twenty-five years ago, studies examining type 2 inflammatory profiles in AFRS can make it seem more alike other CRS subtypes than it is different. Still, evolving research seems to clearly delineate this subtype from others in CRS. This review will critically evaluate the evolution of research examining the pathophysiology of AFRS and will conclude with a summary of the special considerations in the management of this fascinating disease.
文摘Mucormycosis is caused by the fungi belonging to the order Mucorales and class Zygomycetes.The incidence of mucormycosis has increased with the onset of the severe acute respiratory syndrome coronavirus 2 infections leading to the coronavirus disease 2019(COVID-19)pandemic.This rise is attributed to the use of immunosuppressive medication to treat COVID-19 infections.Authors have retrospectively collected data of our cases of mucormycosis diagnosed from April 2020 to April 2021 at our institute.A total of 20 patients with rhinocerebral mucormycosis were studied.Most of the study subjects were male patients(90%)and were of the age group 41-50 years.Most patients in the review had comorbidities(85%)with diabetes being the most common comorbidity.Para nasal sinuses were involved in all the cases.Involvement of the neck spaces was present in 60%of the cases.Involvement of the central nervous system was present in 80%of the cases.Orbital involvement was present in 90%of the cases.The authors reviewed the various imaging findings of mucormycosis on computed tomography and magnetic resonance imaging in this article.
文摘Background:Invasive sphenoid sinus aspergillosis is a rare but life-threatening condition usually found in immunocompromised patients.When involving cavernous sinus and surrounding structures,patients are frequently misdiagnosed with a neoplasm or sellar abscess.Timely diagnosis and intervention are crucial to patients’outcomes.The objective of this study is to review cases of invasive sphenoid sinus aspergillosis to describe disease manifestations,imaging features,treatment,and outcome.Case presentation:We describe four patients with invasive sphenoid sinus aspergillosis misdiagnosed as sellar tumors preoperatively.The mass was completely removed in three patients and partially removed in one patient microscopically.Pathological examinations confirmed Aspergillus in all cases.All four patients received anti-fungal agents postoperatively.There was no recurrence at the time of each patient’s follow-up date.One patient with complete resection was lost to follow-up while the other three patients’neurologic function improved.Additionally,we performed a systematic review regarding invasive sphenoid sinus aspergillosis of existing English literature.Conclusion:With regard to clinical symptoms,headache,vision impairment,and ophthalmoplegia were observed in over half of the patients in the literature.A sellar mass with bone destruction on CT and involvement of cavernous sinus is highly suggestive of invasive fungal sphenoid sinusitis.Immediate surgical removal of the lesion is recommended for invasive sphenoid sinus aspergillosis to preserve nerve function and increase the likelihood of survival.
