scholarly journals Invasive Klebsiella syndrome with coexisting fungal endophthalmitis

2021 ◽  
Vol 16 (2) ◽  
pp. 94-97
Author(s):  
Jayanthi Sugantheran ◽  
Embong Zunaina ◽  
Wan Mariny Md Kasim ◽  
Norlaila Talib
Keyword(s):  
Sphenoid Sinus ◽  
Posterior Segment ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Endogenous Endophthalmitis ◽  
Soft Tissue Density ◽  
Fungal Endophthalmitis ◽  
Uncontrolled Diabetes ◽  
Vascular Arcade ◽  
String Of Pearls

Endogenous endophthalmitis accounts for approximately 5 – 10% of all endophthalmitis cases. We report a case of a middle-aged gentleman with underlying uncontrolled diabetes mellitus who presented with fever and generalised body weakness for one week. He was diagnosed with invasive Klebsiella syndrome based on blood culture with presence of bilateral pleural effusion, liver abscess, renal impairment and sphenoidal sinusitis. The patient developed sudden bilateral painless reduced vision on day two of admission. Ocular examination revealed bilateral severe anterior chamber reaction and severe vitritis that obscured the view of the fundus. Ocular B-scan ultrasonography showed multiple loculations in the posterior segment in both eyes. There was soft tissue density with calcification in the left sphenoid sinus on computed tomography of the orbit. He was treated for bilateral endogenous endophthalmitis with multiple intravitreal antibiotic injections, but showed no improvement. Functional endoscopic sinus surgery was performed and revealed that the left sphenoid sinus was filled with fungal balls. Following drainage of sphenoidal pus, there was resolution of vitritis and fundus examination showed features of underlying fungal infection with a “string of pearls” present along the vascular arcade of both eyes. The patient was diagnosed with bilateral endogenous endophthalmitis secondary to invasive Klebsiella syndrome with coexisting fungal endophthalmitis secondary to sphenoid mycetoma. In addition to repeated intravitreal antibiotic injections, he was also treated with systemic and topical antifungal therapy. At three months post treatment, the infection resolved and his vision improved from counting fingers to 6/36 bilaterally.

Functional endoscopic sinus surgery for isolated sphenoid sinus disease

Head & Neck ◽  
1994 ◽  
Vol 16 (5) ◽  
pp. 433-437 ◽  
Author(s):  
Laurent Gilain ◽  
Didier Aidan ◽  
André Coste ◽  
Roger Peynegre
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Sphenoid Sinus ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Sinus Disease

scholarly journals Image-Guided Sphenoidotomy in Revision Functional Endoscopic Sinus Surgery

2014 ◽  
Vol 5 (3) ◽  
pp. ar.2014.5.0093 ◽  
Author(s):  
Rong-San Jiang ◽  
Kai-Li Liang
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Sphenoid Sinus ◽  
Penetration Rate ◽  
Functional Endoscopic Sinus Surgery ◽  
The Other ◽  
Sinus Surgery ◽  
Image Guided Surgery ◽  
Guided Surgery ◽  
Image Guided ◽  
Senior Surgeon

The application of image-guided systems to sinus surgery is gaining in popularity. This study tried to evaluate the efficacy of image-guided surgery (IGS) in the fenestration of the sphenoid sinus in patients with chronic rhinosinusitis (CRS) who received revision functional endoscopic sinus surgery (FESS). A total of 51 CRS patients who received revision FESS incorporating IGS between January 2010 and August 2011 by two surgeons were enrolled in this study. A group of 30 CRS patients who underwent revision FESS by the senior surgeon without incorporating IGS was chosen for comparison. The penetration rates for the sphenoid sinus were 91.2% when performed by the senior surgeon with IGS and 91.3% when done by the other surgeon with IGS. The penetration rate for the sphenoid sinus was 68.6% for revision FESS without IGS. The fenestration rate for the sphenoid sinus in revision FESS without IGS was significantly lower than that in revision FESS with IGS (p = .004). Our results showed that IGS was a beneficial procedure for opening the sphenoid sinus in the revision cases.

scholarly journals Mucormycosis in a patient with COVID-19 with uncontrolled diabetes

2021 ◽  
Vol 14 (7) ◽  
pp. e245343
Author(s):  
Muhammad Shakir ◽  
Muhammad Hassaan Arif Maan ◽  
Shahan Waheed
Keyword(s):  
Fungal Infections ◽  
Histopathological Examination ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Evidence Based ◽  
Imaging Studies ◽  
Uncontrolled Diabetes ◽  
Wide Range ◽  
High Index Of Suspicion ◽  
Sphenoid Sinuses

A wide range of bacterial and fungal coinfections may be associated with COVID-19. We report a case of rhino-orbital mucormycosis in a patient with COVID-19. A 67-year-old man, known case of diabetes, hypertension and ischaemic heart disease, was being treated for COVID-19 pneumonia when he developed right cheek eschar and ophthalmoplegia. Imaging studies revealed pansinusitis of bilateral maxillary and sphenoid sinuses with thickening and enhancement of right-sided soft tissue, lacrimal gland, mastication muscles, temporal lobe infiltrate and cerebellum infarct. Emergency right face debridement, right eye exenteration and bilateral functional endoscopic sinus surgery were done. Histopathological examination confirmed mucormycosis diagnosis. He was given amphotericin B and broad-spectrum antibiotics. It is important to have high index of suspicion for fungal coinfections in patients with COVID-19 with pre-existing medical conditions. There is a need to emphasise judicious and evidence-based use of immunomodulators in patients with COVID-19 to avoid triggering and flaring up of fungal infections.

scholarly journals Endoscopic Findings of Fungal Ball in the Mucocele After Endonasal Transsphenoidal Surgery

2019 ◽  
pp. 014556131986766
Author(s):  
Jong Seung Kim ◽  
Eun Jung Lee
Keyword(s):  
Transsphenoidal Surgery ◽  
Sphenoid Sinus ◽  
Pituitary Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Fungal Ball ◽  
Endoscopic Findings ◽  
Transseptal Approach ◽  
History Of ◽  
The Right

A 51-year-old woman with headache was referred to our hospital. She had a history of endonasal pituitary surgery 22 years prior and hypertension 10 years prior. The endonasal transsphenoidal pituitary approach was performed via microscopic transseptal approach. Nasal endoscopy revealed whitish cystic wall protruded from the right sphenoid sinus. Functional endoscopic sinus surgery was performed under general anesthesia. After incision of the right sphenoid ostium, yellowish mucoid discharge in the right sphenoid sinus was pushed out from the sphenoid sinus. Histopathology confirmed fungal ball in the sphenoid sinus, which is consistent with aspergillosis sinus. The presence of fungal ball and mucocele are rarely reported, but mucocele and fungal ball found after pituitary surgery are the first and therefore unique in this case.

scholarly journals Isolated sphenoid polyp: a cause of headache

2018 ◽  
Vol 5 (1) ◽  
pp. 228
Author(s):  
J. R. Galagali ◽  
Roohie Singh ◽  
Santosh Kumar
Keyword(s):  
Computed Tomography ◽  
Sphenoid Sinus ◽  
Incidental Finding ◽  
Correct Diagnosis ◽  
Clinical Situation ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Sinus Disease ◽  
Nasal Mass ◽  
History Of

<p class="abstract">Isolated<strong> </strong>sphenoid sinus polyp is a rare clinical situation. It might be an incidental finding while investigating a case of headache. We report a case of 21 years old male who presented with history of headache since 6 months. Diagnostic nasal endoscopy (DNE) revealed a right nasal mass which was confirmed by computed tomography (CT) of paranasal sinuses (PNS). The patient underwent Functional endoscopic sinus surgery (FESS).This paper emphasizes importance of correct diagnosis and consideration of sphenoid sinus disease as differential diagnosis of patients with headache.</p><br /><strong></strong>

scholarly journals Six year old with isolated sphenoidal mucocele and ophthalmopathy – a case report

2013 ◽  
Vol 19 (3) ◽  
pp. 166-169
Author(s):  
M. Lupascu ◽  
Gh. I. Comsa
Keyword(s):  
Case Report ◽  
Endoscopic Sinus Surgery ◽  
Sphenoid Sinus ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Late Development ◽  
Sinus Disease ◽  
Life Threatening

Abstract Sphenoid sinus affections in children are very rare occurrences due to the late development of the sinus and treatment may present quite a challenge even to the most skillful surgeon because of the small nasal fossae. Due to the often vague and uncharacteristic symptomatology sphenoid sinus disease is misdiagnosed and the treatment is delayed, sometimes with serious complications that are life threatening if not properly managed. We present the case of a six year old patient with a mucocele affecting an unusually large sphenoid sinus with concomitant Graves-like ophthalmopathy that has been treated through functional endoscopic sinus surgery but also needed prolonged cortisonic treatment.

scholarly journals Sinoorbital gunshot injuries Endoscopic diagnostics and management

Medicina ◽  
2008 ◽  
Vol 44 (4) ◽  
pp. 308 ◽  
Author(s):  
Svajūnas Balseris ◽  
Dalia Einorienė ◽  
Jonas Martinkėnas ◽  
Rimvydas Toločka
Keyword(s):  
Surgical Management ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Sphenoid Sinus ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Endoscopic Procedures ◽  
Clinical Criteria ◽  
Gunshot Injuries ◽  
Endoscopic Diagnostics

Gunshot injuries to the paranasal sinuses and orbita are uncommon. Their severity depends on missile track in tissues. Such injuries can involve the orbit, paranasal sinuses, or brain. This article reports the main clinical criteria and the aspects of surgical management. Functional endoscopic sinus surgery is the most appropriate technique for removing projectiles left. This article also presents one case of airgun injury to the sphenoid sinus with retained missile that was safely removed using endoscopic procedures.

scholarly journals The physiological and pathophysiological aspects of the sphenoid sinus: a review

2020 ◽  
Vol 7 (1) ◽  
pp. 192
Author(s):  
Manish Munjal ◽  
Suneet Sethi ◽  
Shubham Munjal ◽  
Vidushi Gupta ◽  
Hem Lata Badyal ◽  
...  
Keyword(s):  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Sphenoid Sinus ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Deep Location

<p class="abstract">The sphenoid sinus among the paranasal sinuses, with its deep location and obstruction at the level of its ostium, is the commonest cause of occipital or vertex headache. Limited intervention reverts the intricate mucociliary physiology of the sinus. The surgery, a sphenoidotomy, is aptly captioned, the “functional endoscopic sinus surgery”, for the Sphenoid. The unique physio-pathology of the Sphenoid sinus shall be elaborated.  </p>

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