Invasive Fungal Sinusitis of the Sphenoid Sinus

• DOI: 10.3342/ceo.2014.7.3.181
• Publication Date: 2014-08-07T07:20:43Z
• Authors: Dong Hoon Lee; Tae Mi Yoon; Joon Kyoo Lee; Young Eun Joo; Kyung Hwa Park; Sang Chul Lim
• Keywords: Fungus; Invasive; R; Sphenoid sinus; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Otorhinolaryngology; RF1-547; Medicine; Original Article; Sinusitis

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.A retrospective review of 12 cases of invasive fungal sphenoiditis was conducted.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).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.