title: Invasive fungal sinusitis of the sphenoid sinus.
abstract: OBJECTIVE
  This study was conducted to present the clinical outcome of invasive fungal sinusitis of the sphenoid sinus and to analyze clinical factors influencing patient survival.
  
  
  METHODS
  A retrospective review of 12 cases of invasive fungal sphenoiditis was conducted.
  
  
  RESULTS
  Cases were divided into acute fulminant invasive fungal spheonoidits (n=4) and chronic invasive fungal sphenoiditis (n=8). The most common underlying disease was diabetes mellitus (n=9). The most common presenting symptoms and signs included visual disturbance (100%). Intracranial extension was observed in 8 patients. Endoscopic debridement and intravenous antifungals were given to all patients. Fatal aneurysmal rupture of the internal carotid artery occurred suddenly in two patients. The mortality rate was 100% for patients with acute fulminant invasive fungal sphenoiditis and 25% for patients with chronic invasive fungal sphenoiditis. In survival analysis, intracranial extension was evaluated as a statistically significant factor (P=0.027).
  
  
  CONCLUSIONS
  The survival rate of chronic invasive fungal sphenoiditis was 75%. However, the prognosis of acute fulminant invasive fungal sphenoiditis was extremely poor despite the application of aggressive treatment, thus, a high index of suspicion should be required and new diagnostic markers need to be developed for early diagnosis of invasive fungal sinusitis of the sphenoid sinus.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea.
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea.
authors.forename: Tae Mi
authors.initials: TM
authors.lastname: Yoon
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea.
authors.forename: Joon Kyoo
authors.initials: JK
authors.lastname: Lee
authors.affiliation: Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea.
authors.forename: Young Eun
authors.initials: YE
authors.lastname: Joo
authors.affiliation: Department of Infectious Disease, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea.
authors.forename: Kyung Hwa
authors.initials: KH
authors.lastname: Park
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea.
authors.forename: Sang Chul
authors.initials: SC
authors.lastname: Lim
keywords: Fungus; Invasive; Sinusitis; Sphenoid sinus