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Nasal septal perforation caused by invasive fungal sinusitis
Wai-Tin Kuo1, Ta-Jen Lee, Ying-Lin Chen
1Department of Otolaryngology, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC.
Abstract:
Nasal septal perforation presents a distinct challenge to otorhinolaryngologists, and is a problem for patients. Although it has a variety of causes, previous septal surgery is the most common reason. We present a 57-year-old woman who had recurrent chronic sinusitis. A left nasal mass was noted and excised via endoscopic sinus surgery. Invasive aspergillosis sinusitis was proven both grossly and histopathologically, and a nasal septal perforation was also noted during the operation. Although there has been only a single other case presented by Siberry in 1997, we postulate that perforation of the nasal septum as with the case described herein is a rare complication of invasive fungal sinusitis.
Insights
Nasal septal perforation is a rare complication of invasive fungal sinusitis. This case highlights a potential link between invasive aspergillosis sinusitis and nasal septal perforation, a condition previously reported only once.
Area of Science:
- Otorhinolaryngology
- Mycology
- Surgical Pathology
Background:
- Nasal septal perforation poses significant challenges in otorhinolaryngology.
- Previous septal surgery is the most frequent cause of nasal septal perforation.
- Invasive fungal sinusitis is a serious condition requiring prompt diagnosis and treatment.
Observation:
- A 57-year-old woman with recurrent chronic sinusitis underwent endoscopic sinus surgery.
- A left nasal mass was excised during the procedure.
- Invasive aspergillosis sinusitis was diagnosed both grossly and histopathologically.
- A nasal septal perforation was incidentally noted during the operation.
Findings:
- The patient presented with invasive aspergillosis sinusitis.
- A nasal septal perforation was identified concurrently with the fungal sinusitis.
- This represents the second reported case of nasal septal perforation associated with invasive fungal sinusitis.
Implications:
- Invasive fungal sinusitis may be an underrecognized cause of nasal septal perforation.
- Further research is needed to understand the mechanism and incidence of this rare complication.
- This finding may influence diagnostic and management strategies for invasive fungal sinusitis.