title: Invasive aspergillosis of the paranasal sinuses and the skull base.
abstract: Invasive aspergillosis (IA) originating from the paranasal sinuses can cause an intracranial growth mainly along the skull base and larger vessels. This study reports our experience in the diagnosis and treatment of a series of patients with IA. A retrospective chart review of four patients with chronic invasive intracranial aspergillosis was performed. Clinical signs, physical examinations, radiographs, histological samples, and outcome were demonstrated. The patients demonstrated different symptoms like exophthalmus, ophthalmoplegia, loss of vision, and hypaesthesia of the ophthalmic and maxillary nerve. Computed tomography and MRI revealed extensive sino-orbital and skull base lesions. The patients were treated with aggressive endonasal debridement, intravenous antifungal agents and daily irrigations with antimycotic suspensions. Furthermore, we applied hyperbaric oxygenation. Two patients died from complications due to subarachnoidal hemorrhage and accompanied complications respectively. Despite the high mortality rate patients with an invasive aspergillosis can be effectively treated in some cases by an early and rigorous treatment schedule using all surgical and conservative therapeutic options.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Martin Luther University Halle-Wittenberg, Magdeburger Str 12, Halle/Saale, Germany. Stephan.knipping@medizin.uni-halle.de
authors.forename: Stephan
authors.initials: S
authors.lastname: Knipping
authors.forename: Hans Juergen
authors.initials: HJ
authors.lastname: Holzhausen
authors.forename: Sabrina
authors.initials: S
authors.lastname: Koesling
authors.forename: Marc
authors.initials: M
authors.lastname: Bloching
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D003131:Combined Modality Therapy; D003646:Debridement; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods*; D016867:Immunocompromised Host; D007275:Injections, Intravenous; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010254:Paranasal Sinus Diseases / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D019291:Skull Base / Q000382:microbiology* / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents