scholarly journals The Different Clinical Manifestations and Diagnostic Strategies of Isolated Sphenoid Non-Invasive Fungal Sinusitis

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Ali Almomen
2011 ◽  
Vol 126 (2) ◽  
pp. 152-158 ◽  
Author(s):  
R Chandrasekharan ◽  
M Thomas ◽  
V Rupa

AbstractObjective:To investigate differences in orbital involvement in patients with invasive versus non-invasive fungal sinusitis.Method:One hundred consecutive cases of fungal sinusitis were assessed clinically and by computed tomography scan to evaluate orbital involvement.Results:Clinical orbital involvement was more common in invasive (73.5 per cent) than non-invasive (12.1 per cent) fungal sinusitis (p = 0.000). Computed tomography scanning showed similar orbital involvement in both groups, except for erosion of the floor of the orbit, which was more common in patients with invasive fungal sinusitis (p = 0.01). Extra-ocular muscle enlargement (44.4 vs 4 per cent, p = 0.01) and optic atrophy (44.4 vs 0 per cent, p = 0.003) were more common in chronic than acute invasive fungal sinusitis. Four patients (16 per cent) with acute invasive fungal sinusitis had no evidence of orbital involvement on scanning, despite clinical evidence of optic atrophy.Conclusion:Orbital involvement is more common in invasive than non-invasive fungal sinusitis. The difference is more evident clinically than on computed tomography scanning. Patients with acute invasive fungal sinusitis may have limited evidence of orbital involvement on scanning, despite extensive clinical disease.


2009 ◽  
Vol 56 (3) ◽  
pp. 145-148
Author(s):  
I. Pendjer ◽  
I. Boricic ◽  
V. Arsic ◽  
Z. Dudvarski ◽  
J. Dotlic ◽  
...  

The aim of this paper is to present the current classification of fungal sinusitis and share our experiences in diagnostic procedures and treatment outcomes. The study includes 31 patients operated since 2000-2009. in whome some form of fungal infection had been diagnosed. There were 10 patients with mycetoma, and 16 patients with chronic non-invasive fungal sinusitis, while in five patients allergic fungal sinusitis was proven. All patients were treated postoperatively with topical steroids and irrigation with saline solution, without use of fungicides. Characteristics of chronic non-invasive funga sinusitis and mycetoma are CT with specific opacification and calcification with involement of maxillary sinus unilaterally or bilateral together with pathohistological finding of positive staining by Grocott with the identification of fungi from secret or tissue. Allergic fungal sinusitis is characterized by eosinophilia, positive skin test to fungal allergens, elevated serum level of both specific IgE antibodies to causal fungus and total IgE, as well as, pathohistological finding of allergic mucus which include non-invasive hifa. Fungal sinusitis in immunocompetent patients is classified into the following categories: mycetoma, chronic non-invasive fungal sinusitis, chronic indolent sinusitis (which does not occur in our population) and allergic fungal sinusitis.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
AbdElhamid AbdElhamid Al-Nashar ◽  
Waleed Farag Ezzat ◽  
Mohammed Abdelaleem Mohammed ◽  
Mohammed Al-Shahat Ibrahim Al-Bahet

Abstract Background Fungal sinusitis is generally classified into invasive and non invasive fungal sinusitis based on histological features, invasive fungal sinusitis divided into acute, chronic and chronic granulomatous invasive fungal sinusitis. While non invasive fungal sinusitis include saprophytic fungal infestation, fungal ball, and fungus-related eosinophilic. Distinguishing invasive disease from noninvasive disease is important because the treatment and prognosis are different for each. AIM A systemic review of effective and safe method in management of different types of fungal sinusitis either by medical or surgical approaches or even combined. Be up to date with the different upcoming new modalities. Methodology A meta-analysis study is done to evaluate the medical and surgical outcomes of patients with invasive and noninvasive Fungal Sinusits. Results Finally, forty-five studies were included in the present systematic review and metaanalysis. Fifteen included studies (No = 539 patients) assessed different modalities for management of fungal ball, via classic endoscopic technique, Canine-fossa approach, gauze technique and osteoplastic approach for FB of the maxillary sinus. The results showed that functional endoscopic sinus surgery has led to success rate of 98.1%. Twenty included studies (No = 806 patients) have assessed the efficacy and safety of different modalities for the management of allergic fungal sinusitis via,Endoscopic Sinus Surgery, Post-ESS Systemic steroids, Antifungals and immunotherapy. The results showed that ESS represents the firstline management strategy of AFRS, followed by aggressive medical therapies, the recurrence rate after postoperative steroids was 20.6%, postoperative antifungals was 40% and after immunotherapy was 9.1%. Ten studies (No = 327 patients) for Invasive Fungal Sinusitis.the results showed that combination of systematic antifungal therapy and aggressive surgical debridement are the treatment of choice. Conclusion FESS is the treatment of choice of fungal ball via classic endoscopic technique, Canine-fossa approach, gauze technique and osteoplastic approach. AFS treatment consists of surgical extirpation of the allergic mucin and polyps with maintenance of adequate sinus drainage followed by medical therapy consists of topical steroids, anti fungal therapy, Immunotherapy, and systemic corticosteroids. Treatment of invasive fungal sinusitis includes surgical resection of necrotic tissues, systemic antifungal therapy and reversal of immune dysfunction.


2017 ◽  
Vol 22 (1) ◽  
pp. 67 ◽  
Author(s):  
Rasoul Mohammadi ◽  
Abdolrasoul Mohammadi ◽  
SeyedMostafa Hashemi ◽  
SayedHamidreza Abtahi ◽  
SeyedMohammad Lajevardi ◽  
...  

2019 ◽  
Vol 12 (4) ◽  
pp. e229094 ◽  
Author(s):  
Thomas Hendriks ◽  
Samuel Leedman ◽  
Mark Quick ◽  
Aanand Acharya

A 33-year-old man presented to the emergency department with a right-sided facial paralysis and maxillary division (V2, trigeminal nerve) paraesthesia. He had been suffering with upper respiratory tract symptoms in the preceding 2 months, including rhinorrhoea, fever and headache. The patient was otherwise fit and immunocompetent. Urgent radiological investigation revealed extensive fungal sinusitis with sphenoid sinus dehiscence and skull base osteitis. The patient underwent emergency endoscopic sinus surgery revealing concretions and debris in the ethmoid and sphenoid sinuses. He was commenced on systemic antifungal therapy and made a full recovery with resolution of his cranial neuropathies. The fungusSchizophyllum communewas isolated and is a rare cause of fungal sinusitis, but with the potential for invasive disease in immunosuppressed individuals.


2021 ◽  
Author(s):  
Noha Ahmed El‐Kholy ◽  
Ahmed Musaad Abd El‐Fattah ◽  
Yasser W. Khafagy

2014 ◽  
Vol 128 (11) ◽  
pp. 1018-1021 ◽  
Author(s):  
A Hariri ◽  
N Choudhury ◽  
H A Saleh

AbstractBackground:Scytalidium dimidiatum is a soil and plant pathogen that frequently affects fruit trees, but can also cause human infection. There are only two reported cases of invasive fungal sinusitis involving this rare micro-organism.Objective:This paper reports the first case of invasive fungal sinusitis caused by Scytalidium dimidiatum occurring in a young immunocompetent patient from a non-endemic region, and discusses potential sources of exposure and relevance of local factors.Method:Case report.Results:The patient was treated successfully with a combination of functional endoscopic sinus surgery, and antifungal and corticosteroid treatment.Conclusion:This paper describes the first reported case of invasive fungal sinusitis secondary to Scytalidium dimidiatum in a young immunocompetent patient from a non-endemic region. Importance is placed on following a systematic process of investigation and management, and adhering to well-defined basic surgical principles.


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