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Chronic Granulomatous Invasive Fungal Sinusitis in Patients With Immunocompetence: A Review.
- Source :
- Otolaryngology-Head & Neck Surgery; Apr2023, Vol. 168 Issue 4, p669-680, 12p
- Publication Year :
- 2023
-
Abstract
- Objective: We aimed to study the literature on chronic granulomatous invasive fungal sinusitis to elucidate the changing trends in the management of the disease. Data Sources: Using specific keywords, we searched the PubMed, PubMed Central, and Scopus databases over the past 50 years, which yielded 938 articles in the English language. Review Methods: Scrutiny of 147 relevant articles revealed 15 homogenous case series (255 cases of histologically proven chronic granulomatous fungal sinusitis alone) and 8 heterogeneous case series (patients with other types of fungal sinusitis included), which were analyzed in detail (all with >5 cases each). Conclusions: The disease typically affected middle‐aged adults with immunocompetence. Most reports were from Sudan, India, and Saudi Arabia. A slowly progressive orbital, cheek, or palatal mass with proptosis (88.2%) or sinonasal symptoms (39.2%) was typical. Ethmoid (57.2%) and maxillary (51.4%) sinuses were chiefly affected with intracranial extension in 35.1%. Aspergillus flavus (64%) was the most frequent isolate reported. Endoscopic excision (78.8%) followed by azole therapy was the preferred treatment in recent reports. Orbital exenteration and craniotomy were infrequently performed. Complete resolution or improvement was reported in 91.3% of patients. Mortality ranged from 5.9% to 22.2%. There is a trend in the literature toward less radical and disfiguring surgery and preferential use of azoles, with good outcomes even in advanced cases. Implications for Practice: Chronic granulomatous fungal sinusitis should be diagnosed on the basis of well‐defined histopathologic features. A combination of endoscopic sinus surgery and azole therapy usually yields good outcomes. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 01945998
- Volume :
- 168
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- Otolaryngology-Head & Neck Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 162669887
- Full Text :
- https://doi.org/10.1177/01945998221097006