Updates in management of acute invasive fungal rhinosinusitis

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John R Craig1

  • 1Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, Grand Blvd, Detroit, Michigan, USA.

Current Opinion in Otolaryngology & Head and Neck Surgery
|December 27, 2018
PubMed
Abstract

Insights

Early diagnosis and treatment are crucial for improving survival rates in acute invasive fungal rhinosinusitis (AIFRS). Prompt surgical debridement and antifungal therapy are key management strategies for this rare, often fatal condition.

Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Pathology

Background:

  • Acute invasive fungal rhinosinusitis (AIFRS) is a rare, severe, and often fatal condition with limited understanding.
  • Current literature primarily consists of case series and reviews, guiding treatment for complex patients.

Purpose of the Study:

  • To review and discuss optimal diagnostic and therapeutic strategies for managing AIFRS.
  • To highlight recent advancements in the diagnosis and treatment of AIFRS.

Main Methods:

  • Literature review focusing on diagnostic and therapeutic approaches for AIFRS.
  • Analysis of recent studies on frozen section analysis and surgical resection outcomes.
  • Evaluation of new antifungal agents.

Main Results:

  • Mortality for AIFRS remains high (around 50%), but early diagnosis and complete surgical resection show improved survival.
  • Frozen section analysis is valuable for diagnosing AIFRS and assessing surgical resection completeness.
  • A new FDA-approved antifungal agent offers a favorable profile, pending further study.

Conclusions:

  • Early AIFRS diagnosis involves recognizing sinusitis symptoms in immunocompromised individuals, followed by intranasal biopsy and frozen section analysis.
  • Cornerstones of AIFRS management include early surgical debridement and prompt antifungal therapy.

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