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Scientific Reports Apr 2024Potentially fatal fungal sphenoid sinusitis (FSS) causes visual damage. However, few studies have reported on its visual impairment and prognosis. Five hundred and...
Potentially fatal fungal sphenoid sinusitis (FSS) causes visual damage. However, few studies have reported on its visual impairment and prognosis. Five hundred and eleven FSS patients with ocular complications treated at Beijing Tongren Hospital were recruited and clinical features and visual outcomes were determined. Thirty-two of the 511 patients (6%) had visual impairment, with 13 and 19 patients having invasive and noninvasive FSS, respectively. Eighteen patients (56.25%) had diabetes and 2 patient (6.25%) had long-term systemic use of antibiotics (n = 1) and corticosteroids (n = 1). All patients had visual impairment, which was more severe in invasive FSS than in noninvasive FSS. Bony wall defects and sclerosis were observed in 19 patients (59.38%), and 11 patients (34.38%) had microcalcification in their sphenoid sinusitis on computed tomography (CT). After a 5-year follow-up, three patients (9.38%) died. Patients with noninvasive FSS had a higher improvement rate in visual acuity than their counterparts. In the multivariate analysis, sphenoid sinus wall sclerosis on CT was associated with better visual prognosis. FSS can cause vision loss with persistent headaches, particularly in those with diabetes. CT showed the sphenoid sinus wall sclerosis, indicating a better visual prognosis in FSS with visual impairment.
Topics: Humans; Sphenoid Sinusitis; Sclerosis; Sinusitis; Mycoses; Vision Disorders; Vision, Low; Retrospective Studies; Diabetes Mellitus
PubMed: 38622183
DOI: 10.1038/s41598-024-59107-2 -
Journal of the National Medical... Jan 1991Significant morbidity and mortality can result if early detection and treatment of sphenoid sinusitis is not provided. A case is presented in which the diagnosis of...
Significant morbidity and mortality can result if early detection and treatment of sphenoid sinusitis is not provided. A case is presented in which the diagnosis of sphenoid sinusitis was delayed because a routine computerized tomographic scan was normal. This case underscores the importance of specifically requesting views of the paranasal sinuses in suspected cases of sinusitis.
Topics: Adolescent; Humans; Male; Sphenoid Sinusitis; Tomography, X-Ray Computed
PubMed: 1994073
DOI: No ID Found -
Ear, Nose, & Throat Journal Jun 2023Cavernous sinus thrombosis (CST) is a rare but life-threatening infectious disease whose diagnosis and treatment are challenging. CST can result in ocular and neurologic...
Cavernous sinus thrombosis (CST) is a rare but life-threatening infectious disease whose diagnosis and treatment are challenging. CST can result in ocular and neurologic morbidities, as well as fatal systemic complications due to systemic thrombus. Occasionally, these clinical symptoms can be a result of contralateral sinusitis. A 75-year-old female presented with severe headache and fever. Magnetic resonance imaging revealed a multifocal filling defect in both cavernous sinuses, with heterogeneous enhancement and thrombosis of the right superior ophthalmic vein. Intravenous antibiotic was administered, and endoscopic sinus surgery was performed. The patient was discharged 40 days after admission and there were no neurologic symptoms and no evidence of sequelae during the 10-month follow-up. Symptoms of CST on the contralateral side are often missed, which delays initiation of appropriate treatment. When CST secondary to paranasal sinusitis is diagnosed, clinicians should consider contralateral as well as ipsilateral infection of the paranasal sinus. Preventing disease progression and complications through early and aggressive antibiotic administration along with sinus surgery is crucial.
PubMed: 37317546
DOI: 10.1177/01455613231181217 -
Neuroradiology Aug 2023The sphenoid sinus (SS) is one of the four paired paranasal sinuses (PNSs) within the sphenoid bone body. Isolated pathologies of sphenoid sinus are uncommon. The...
The sphenoid sinus (SS) is one of the four paired paranasal sinuses (PNSs) within the sphenoid bone body. Isolated pathologies of sphenoid sinus are uncommon. The patient may have various presentations like headache, nasal discharge, post nasal drip, or non-specific symptoms. Although rare, potential complications of sphenoidal sinusitis can range from mucocele to skull base or cavernous sinus involvement, or cranial neuropathy. Primary tumors are rare and adjoining tumors secondarily invading the sphenoid sinus is seen. Multidetector computed tomography (CT) scan and magnetic resonance imaging (MRI) are the primary imaging modalities used to diagnose various forms of sphenoid sinus lesions and complications. We have compiled anatomic variants and various pathologies affecting sphenoid sinus lesions in this article.
Topics: Humans; Sphenoid Sinus; Paranasal Sinus Diseases; Sphenoid Sinusitis; Multidetector Computed Tomography; Magnetic Resonance Imaging; Mucocele
PubMed: 37202536
DOI: 10.1007/s00234-023-03163-4 -
Atypical Skull-Base Osteomyelitis: Comprehensive Review and Multidisciplinary Management Viewpoints.Tropical Medicine and Infectious Disease Apr 2023Atypical skull-base osteomyelitis is a rare but fatal disease that usually involves infection of the ethmoid, sphenoid, occipital, or temporal bones that form the skull... (Review)
Review
Atypical skull-base osteomyelitis is a rare but fatal disease that usually involves infection of the ethmoid, sphenoid, occipital, or temporal bones that form the skull base. Unlike typical (so-called otogenic), atypical skull-base osteomyelitis has no otogenic cause. Instead, some authors call atypical skull-base osteomyelitis sinonasal, since the infection most often originates from the nose and paranasal sinuses. Diagnosing and treating this disease is challenging. To assist in managing atypical skull-base osteomyelitis, a review of the most recent literature, with patient cases and multidisciplinary perspectives from otolaryngologists, neurosurgeons, radiologists, infectious disease specialists, pathologists, and clinical microbiologists, is provided in this paper.
PubMed: 37235302
DOI: 10.3390/tropicalmed8050254 -
CMAJ : Canadian Medical Association... Aug 2021
Topics: Adolescent; Cavernous Sinus; Humans; Male; Sphenoid Sinusitis; Thrombosis
PubMed: 34400491
DOI: 10.1503/cmaj.201317-f -
International Journal of Otolaryngology 2022Fungal ball sinusitis is a sinonasal fungus ball that usually affects immunocompetent adults with female predominance. The most affected sinus is the maxillary sinus....
BACKGROUND
Fungal ball sinusitis is a sinonasal fungus ball that usually affects immunocompetent adults with female predominance. The most affected sinus is the maxillary sinus. species is the most typically found fungus. Computed tomography (CT) scan is the gold standard tool in order to diagnose fungal ball sinusitis. The ultimate method for a fungal ball is functional endoscopic sinus surgery (FESS), which has a high success rate and a low morbidity rate.
OBJECTIVE
This study aims to demonstrate the various clinical presentations of fungal ball sinusitis including isolated maxillary sinus, sphenoid sinus, simultaneous occurrence of maxillary and sphenoid fungal ball, and post endonasal endoscopic pituitary surgery fungal ball with various age groups. Also, this study aims to emphasize the importance of early diagnosis and treatment in such cases. . A retrospective study that was carried in the otorhinolaryngology department of two hospitals: King Fahad Specialist Hospital and Qatif Central Hospital, Eastern Region, Saudi Arabia. The study was conducted on a total of 16 patients who were diagnosed with paranasal sinuses fungal ball in an 11-year period from January 2008 and November 2019.
RESULTS
Out of 16 patients with paranasal sinuses fungal ball, 11 cases were female and 5 males, with age ranging between 16 and 46 years. Results showed eight isolated sphenoid (50%), six isolated maxillary fungal ball (38%), one simultaneous occurrence of the sphenoid and maxillary fungal ball (6%), and one post endonasal endoscopic pituitary surgery for pituitary adenoma (6%). CT scan was performed for all 16 cases which is the standard tool for the diagnosis of the fungal ball.
CONCLUSION
Fungal ball may present with variety of symptoms but most commonly with postnasal discharge (PND), headache, and facial pain. CT sinuses is the diagnostic radiological modality to confirm the diagnosis. The FESS functional endoscopic sinus surgery is the gold safe approach for patients with fungal ball to manage their symptoms, confirm the diagnosis, and removal of disease with no morbidities.
PubMed: 35360416
DOI: 10.1155/2022/6721896 -
Cureus Aug 2023sinusitis is an opportunistic fungal infection that is difficult to treat due to its inherent resistance to many antifungal agents. Infections may cause both localized...
sinusitis is an opportunistic fungal infection that is difficult to treat due to its inherent resistance to many antifungal agents. Infections may cause both localized or disseminated disease usually in skin and soft tissues. Immunocompetent persons are typically unaffected and disseminated disease occurs in immunocompromised hosts. is a common hyaline mold causing sinopulmonary disease in those with hematologic malignancies and neutropenia. A 38-year-old Caucasian male with a medical history significant for HIV with intermittent treatment compliance, high-grade diffuse large B cell lymphoma (DLBCL) on chemotherapy, and hemophagocytic lymphohistiocytosis (HLH) presented with right-sided facial pain and fever. Maxillofacial computed tomography (CT) showed thickening and opacification of the sphenoid and maxillary sinuses concerning for fungal sinusitis. Endoscopic transsphenoidal debridement showed fungal growth of and the patient's blood cultures were ultimately negative. The patient underwent debridement of fungal sinusitis as well as right medial maxillectomy and ethmoidectomy. A three-month course of voriconazole was started and completed with weekly liver enzyme tests to monitor medication side effects. He has since been observed well as an outpatient with his oncologist after three months loss to follow-up and his infection has resolved.
PubMed: 37711912
DOI: 10.7759/cureus.43475 -
Case Reports in Dentistry 2022Fungal sinusitis of the paranasal sinuses is a rare infection in healthy individuals but is relatively common in immunocompromised patients. It is often misdiagnosed and...
Fungal sinusitis of the paranasal sinuses is a rare infection in healthy individuals but is relatively common in immunocompromised patients. It is often misdiagnosed and frequently a severe disease, as a few forms of it are linked with a higher mortality rate. Effective handling necessitates a speedy analysis and often counts on radiological findings. On cone-beam computed tomography (CBCT) analysis, a bulky polypoid-shaped lesion with a density close to that of soft tissue in CBCT was visualized in the right ethmoid and sphenoid sinuses. There was a significant expansion of the borders of the right ethmoid sinus, and discontinuity or perforation of the sphenoid sinus floor was suspected from CBCT images. Non-contrasted multi-detector computed tomography (MDCT) exhibited opacification and extension of the lesion into the majority of sinuses with dense inspissated materials in the center, which resembled radiographic features of invasive fungal sinusitis. Computed tomography (CT) scan of the maxillofacial region, specifically paranasal sinuses, plays a considerable role in diagnosing fungal sinusitis. In a majority of cases, fungal sinusitis is noticed and diagnosed in immunocompromised patients. However, it is also seen in healthy patients in very rare circumstances, similar to the patient in this report. If the patient is treated rapidly, the prognosis is fair. We present a case of fungal sinusitis in an otherwise healthy young male patient to increase awareness among dental professionals.
PubMed: 36105627
DOI: 10.1155/2022/3694968 -
Laryngoscope Investigative... Dec 2022An increased incidence of acute invasive fungal sinusitis associated with the recent COVID-19 pandemic has been observed, which is considered a public health concern....
OBJECTIVES
An increased incidence of acute invasive fungal sinusitis associated with the recent COVID-19 pandemic has been observed, which is considered a public health concern. This study aims to detect the incidence, risk factors, causative agents, clinical presentations, outcomes, and susceptibility rate of various antifungals.
METHODS
In this cross-sectional cohort study, a total of 30 patients showing acute invasive fungal rhinosinusitis following a COVID-19 infection were investigated. Histopathological biopsies, culture identification, and molecular confirmation of the causative agents were conducted. The demographic data, risk factors, clinical presentations, treatment regimen and its outcomes, and efficacy of antifungals were listed and analyzed.
RESULTS
A total of 30 cases with a mean age of 59.6 ± 11.9 years were included. Diabetes mellitus was the most recorded comorbidity with a rate of 86.7%, whereas most of the patients received corticosteroids. The mycological examination confirmed the existence of () and () in 96.7% and 3.3% of the cases, respectively. Various stages of sinonasal involvement (ethmoid, maxillary, sphenoid, and inferior turbinate) represented 100%, 83.3%, 66.7%, and 86.7% of the cases, respectively. Headache and facial pain, ophthalmoplegia, visual loss, and blindness represented 100%, 66.7%, 90%, and 53.3% of the cases, respectively. All the cases were simultaneously treated with surgical debridement and amphotericin B. Moreover, . was susceptible to it, whereas . was sensitive to voriconazole, resulting in a survival rate of 86.7% (26/30). The . and . isolates were proven to be sensitive to acetic acid, ethyl alcohol, formalin, and isopropyl alcohol.
CONCLUSIONS
In patients with COVID-19, the diagnosis of acute invasive fungal sinusitis and prompt treatment with antifungal medicine and surgical debridement are important in achieving better outcomes and survival rates.
LEVEL OF EVIDENCE
4.
PubMed: 36544940
DOI: 10.1002/lio2.956