An evaluation of invasive fungal sinusitis outcomes with subsite analysis and use of frozen section analysis.

Authors

• James Foshee
• Chris Luminais
• James Casey
• Alexander Farag
• Anthony Prestipino
• Alfred Marc Iloreta
• Gurston Nyquist
• Marc Rosen

Publication/Presentation Date

8-1-2016

Abstract

BACKGROUND: Invasive fungal sinusitis (IFS) is an aggressive mycosis of the nasal cavity with frequent extension to adjacent structures. Occurring more commonly in immunocompromised individuals, prognosis is typically poor despite aggressive treatment. This study aims to examine postoperative outcomes and survival of a cohort of fungal sinusitis patients at an academic center, as well as identify causes of death in IFS patients.

METHODS: This study was a retrospective chart review of patient charts and departmental records, yielding patient demographics, medical and surgical treatments, pathology records, and outcomes data.

RESULTS: Twenty-seven patients were identified from departmental records between 1998 and 2014. Twenty-one patients presented with Mucor infections, whereas the remaining 6 patients had Aspergillus. All patients were immunocompromised: diabetes (n = 14) and hematologic malignancy (n = 13). Three patients had multiple causes of immunosuppression. Most commonly involved subsites were the maxillary, ethmoid, and sphenoid sinuses. Nasal septum involvement was independently associated with mortality (p < 0.01). Overall mortality was 57.7% within 1 year, although 66.7% of fatalities occurred within 1 month of diagnosis.

CONCLUSION: Overall survival for IFS remains poor. Widespread disease and nasal septum involvement were associated with a negative clinical course. Early identification and aggressive surgical and antifungal therapy is warranted. Even despite intense therapy, comorbid conditions and drug toxicity increase mortality and complicate the clinical course.

Volume

6

Issue

8

First Page

807

Last Page

811

ISSN

2042-6984

Published In/Presented At

Foshee, J., Luminais, C., Casey, J., Farag, A., Prestipino, A., Iloreta, A. M., Nyquist, G., & Rosen, M. (2016). An evaluation of invasive fungal sinusitis outcomes with subsite analysis and use of frozen section analysis. International forum of allergy & rhinology, 6(8), 807–811. https://doi.org/10.1002/alr.21714

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

27272979

Department(s)

Administration and Leadership

Document Type

Article