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Head and neck mycetoma
S Supanakorn1, S Rungruxsirivorn, A Patradul
1Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Summary
Eumycotic mycetomas in the head and neck are rare fungal infections. Treatment varies from complete excision for localized cases to surgery and antifungals for extensive disease, with fair prognosis in complex scenarios.
Area of Science:
- Mycology
- Surgical Pathology
- Head and Neck Surgery
Background:
- Eumycotic mycetoma is a chronic granulomatous fungal infection.
- Head and neck mycetomas are uncommon, presenting diagnostic and therapeutic challenges.
- Understanding the diverse clinical presentations is crucial for effective management.
Observation:
- Reported are two cases of eumycotic mycetoma in the head and neck.
- Case 1: Localized soft tissue neck mycetoma successfully treated with complete excision.
- Case 2: Extensive mycetoma involving parapharyngeal, submandibular spaces, and carotid sheath up to the skull base.
Findings:
- Complete excision was curative for the localized neck mycetoma.
- The extensive case required combined surgical resection (radial forearm flap reconstruction) and antifungal therapy.
- Prognosis for the extensive head and neck mycetoma remains fair, indicating potential for recurrence or complications.
Implications:
- Surgical management is key, with complete excision being ideal for localized disease.
- Aggressive, multi-modal treatment is necessary for extensive head and neck mycetomas.
- Further research into optimal antifungal strategies and long-term outcomes for complex cases is warranted.