title: Non-randomized comparison of surgical modalities for paranasal sinus mycoses with intracranial extension.
abstract: Mycotic infections of paranasal sinuses are frequently reported in southern Asia. Aspergillus and Mucor species are the predominant ones. Intracranial extension of paranasal sinus mycoses is a difficult problem to manage. We report 18 cases of paranasal sinus mycoses with intracranial extensions. The commonest manifestations were nasal discharge (67%), nasal obstruction (50%), ocular symptoms such as proptosis (44%), telecanthus (39%) and ophthalmoplegia. Computerized tomography scans were found to be quite informative regarding the nature and extent of the disease (100% sensitivity and 78% specificity). A combined intracranial-extracranial approach (six cases) gave a distinct advantage over only adopting an extracranial approach (12 cases). A 17% incidence of CSF leak was noted by adopting only an extracranial approach as well as a recurrence in four cases out of the 12 that were treated using this method (P < 0.05). A slight increase in morbidity was associated with the combined intracranial-extracranial treatment, but no recurrence or significant complications were noted in this approach.
authors.affiliation: Department of Otolaryngology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: A K
authors.initials: AK
authors.lastname: Gupta
authors.forename: S B
authors.initials: SB
authors.lastname: Mann
authors.forename: V K
authors.initials: VK
authors.lastname: Khosla
authors.forename: K V
authors.initials: KV
authors.lastname: Sastry
authors.forename: J S
authors.initials: JS
authors.lastname: Hundal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001228:Aspergillosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009091:Mucormycosis / Q000601:surgery*; D009916:Orbital Diseases / Q000382:microbiology / Q000628:therapy; D010254:Paranasal Sinus Diseases / Q000150:complications / Q000382:microbiology / Q000601:surgery*; D012852:Sinusitis / Q000382:microbiology / Q000601:surgery; D014057:Tomography, X-Ray Computed