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Updated: Mar 2, 2026

Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
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Invasive aspergillus sinusitis with orbitocranial extension.

Saleh S Baeesa1, Rakan F Bokhari1, Khalid B Alghamdi2

  • 1Division of Neurosurgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.

Asian Journal of Neurosurgery
|May 10, 2017
PubMed
Summary
This summary is machine-generated.

Surgical management of invasive sinonasal aspergillosis with orbitocranial extension, combined with antifungal therapy, offers good outcomes. Complete fungal burden removal is key for successful treatment and minimal morbidity in these challenging cases.

Keywords:
Fungal brain abscessintracranial fungal granulomainvasive aspergillus sinusitisisolated sphenoiditismycotic fungal cerebral aneurysm

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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.