Invasive aspergillus sinusitis with orbitocranial extension

Area of Science:

• Otolaryngology
• Neurosurgery
• Infectious Diseases

Background:

• Invasive sinonasal aspergillosis is a progressive fungal infection.
• Untreated cases can spread to the brain and orbits, causing severe complications.
• Early diagnosis and intervention are crucial to prevent significant morbidity.

Purpose of the Study:

• To evaluate the outcomes of a collaborative surgical approach for invasive sinonasal aspergillosis.
• To assess the effectiveness of combined surgical and antifungal treatment for orbitocranial extension.
• To analyze the morbidity and success rates of surgical management in complex cases.

Main Methods:

• Retrospective study of 12 patients treated between 2000 and 2012.
• Utilized CT, MRI, and cerebral angiography for diagnosis and surgical planning.
• Employed combined transcranial and endonasal surgical approaches with adjuvant antifungal therapy.

Main Results:

• Headache and nasal obstruction were common presenting symptoms.
• Complications included proptosis, meningitis, epilepsy, subarachnoid hemorrhage (SAH), and trigeminal neuralgia.
• Disease eradication was achieved in 67% of patients; 25% experienced recurrence. Mortality was linked to SAH.

Conclusions:

• Surgical intervention is vital for managing invasive sinonasal aspergillosis with orbitocranial extension.
• Adjuvant antifungal therapy improves treatment efficacy.
• Aiming for complete fungal removal leads to minimal morbidity and favorable outcomes.