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[Case of invasive sino-orbital aspergillosis developing orbital apex syndrome]

Yuuta Kamoshima1, Yutaka Sawamura, Yoshinobu Iwasaki

  • 1Department of Neurosurgery, Hokkaido University Graduate School of Medicine, 15-7 Kita-ku, Sapporo 060-8638, Japan.

No Shinkei Geka. Neurological Surgery
|November 1, 2007
PubMed

Insights

This case report details a successful treatment for sino-orbital invasive aspergillosis, a typically lethal condition. Surgical resection combined with antifungal therapy offers a viable option for this aggressive fungal infection.

Area of Science:

  • Ophthalmology
  • Neurosurgery
  • Infectious Diseases

Background:

  • Sino-orbital invasive aspergillosis is a rare and often fatal fungal infection.
  • Early diagnosis and aggressive management are crucial for patient outcomes.

Observation:

  • A 65-year-old female presented with progressive visual disturbance, diplopia, ptosis, and severe periorbital pain.
  • MRI revealed a mass extending from the orbital apex to the cavernous sinus.
  • Biopsy confirmed invasive sino-orbital aspergillosis, which progressed despite medical management.

Findings:

  • Radical surgical excision of the aspergilloma via craniotomy, involving the orbit and cavernous sinus, was performed.
  • Trigeminal nerve rhizotomy was conducted concurrently to manage intractable pain.
  • The patient experienced remarkable pain amelioration post-surgery.

Implications:

  • This case highlights the potential for successful surgical and medical management of sino-orbital invasive aspergillosis.
  • Radical resection and pain management strategies can significantly improve quality of life.
  • Long-term antifungal therapy, such as voriconazole, may prevent disease recurrence.

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