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Invasive fungal rhinosinusitis versus bacterial rhinosinusitis with orbital complications: a case-control study

Patorn Piromchai1, Sanguansak Thanaviratananich

  • 1Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.

Thescientificworldjournal
|December 4, 2013
PubMed
Abstract

Insights

Invasive fungal rhinosinusitis with orbital complications (IFSwOC) is a serious condition. Diabetes mellitus is a key risk factor, and early detection of symptoms like visual loss is crucial for managing IFSwOC and reducing its high mortality rate.

Area of Science:

  • Otolaryngology
  • Ophthalmology
  • Infectious Diseases

Background:

  • Invasive fungal rhinosinusitis with orbital complications (IFSwOC) presents a significant threat with a high mortality rate, potentially up to 80%.
  • Prompt identification of risk factors and clinical presentations is essential for effective management.

Purpose of the Study:

  • To identify risk factors associated with IFSwOC.
  • To analyze clinical and imaging findings for early diagnosis and management.
  • To determine predictors of mortality in IFSwOC patients.

Main Methods:

  • A case-control study involving 100 patients with rhinosinusitis and orbital complications.
  • Data collection included risk factors, clinical presentations, radiological findings, management strategies, hospital stay duration, and mortality rates.

Main Results:

  • Diabetes mellitus was identified as the primary risk factor for IFSwOC.
  • Visual loss and diplopia were significant symptom predictors; nasal crust, oculomotor, and optic nerve involvement were key clinical predictors.
  • CT scans revealed sinus wall erosion and hyperdensity lesions in IFSwOC patients. The mortality rate was 25.71% in the IFSwOC group versus 3.17% in the control group.

Conclusions:

  • IFSwOC is associated with a high mortality rate, underscoring the need for prompt recognition and intervention.
  • Awareness of patient risk factors, presenting symptoms, and signs of fungal invasion are critical.
  • Aggressive management strategies are paramount for improving treatment outcomes in IFSwOC.

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