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Treatment outcomes in acute invasive fungal rhinosinusitis

Maria G Zuniga1, Justin H Turner

  • 1Department of Otolaryngology Head and Neck Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.

Current Opinion in Otolaryngology & Head and Neck Surgery
|April 24, 2014
PubMed
Abstract

Insights

Acute invasive fungal rhinosinusitis (AIFR) treatment combines antifungals and surgery. Outcomes improve with surgical resection and managing reversible factors, though survival rates remain below 60%.

Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Mycology

Background:

  • Acute invasive fungal rhinosinusitis (AIFR) is a severe, often fatal infection.
  • Presentation and survival rates for AIFR vary significantly in published literature.
  • This review focuses on treatment outcomes for AIFR.

Purpose of the Study:

  • To review and discuss treatment outcomes for acute invasive fungal rhinosinusitis.
  • To analyze factors influencing survival rates in AIFR patients.

Main Methods:

  • Review of existing case reports and small case series on AIFR.
  • Analysis of treatment strategies including medical therapy and surgical intervention.
  • Evaluation of recent studies on AIFR management and outcomes.

Main Results:

  • Combined medical therapy (intravenous antifungals) and surgical resection/debridement are standard AIFR treatments.
  • Few large-scale studies exist due to AIFR rarity, with limited changes in management or outcomes over time.
  • Survival rates for AIFR remain below 60%.

Conclusions:

  • Surgical/endoscopic resection and management of reversible predisposing factors (e.g., diabetes) significantly improve AIFR patient outcomes.
  • The role of orbital exenteration in AIFR treatment outcomes requires further clarification, with recent data suggesting limited impact for most patients.

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