[Clinical analysis of chronic invasive fungal rhinosinusitis].
OBJECTIVE
To investigate the clinical features and treatment of chronic invasive fungal rhinosinusitis(CIFRS).


METHODS
From June 2006 to August 2011, seven patients were pathologically diagnosed as CIFRS in otorhinolaryngology department of Peking university first hospital and included in this study. The clinical records were reviewed. The clinical features, clinical course, symptoms, clinical signs, CT/MRI scan of the sinuses, surgical approach, postoperative pathology and medications were analyzed retrospectively. These 7 patients received both surgical and systemic anti-fungal treatment. Among them, 2 cases with characteristically clinical features were addressed into further analyses to explore the clinical feature and treatment of CIFRS.


RESULTS
Among the 7 patients, 5 were female and 2 were male. The course of diseases were from 2 months to 8 years. All patients had no systemic immune diseases and history of diabetes mellitus, while 1 case had a history of facial trauma, and another 1 case had received antibiotics for long-stay in bed after a car accident. The onset lesions of 6 cases were in unilateral maxillary sinus and 1 in unilateral ethmoid sinus. Aspergillus fungi were detected in 6 cases and mold fungi were detected in 1 case by pathology or fungal culture. After follow-up for 1-5 years, 6 patients were cured, and 1 was died.


CONCLUSIONS
CIFRS are often diagnosed in patients with normal immune function. Lesions alwasys occur in single sinus, and maxillary sinus is the most commonly involved.Aspergillus is the most common pathogens. Early clinical manifestation and sinus CT images are lack of specificity. Surgery associated with adequate antifungal treatment might be the best treatment strategy.
Department of Otorhinolaryngology- Head and Neck Surgery, Peking University First Hospital, Beijing 100034, China.
T C
TC
Li
Department of Otorhinolaryngology- Head and Neck Surgery, Peking University First Hospital, Beijing 100034, China.
Z G
ZG
Zeng
Department of Otorhinolaryngology- Head and Neck Surgery, Peking University First Hospital, Beijing 100034, China.
S F
SF
Xiao
Department of Otorhinolaryngology- Head and Neck Surgery, Peking University First Hospital, Beijing 100034, China.
Y
Y
Qin
Imaging Department, Peking University First Hospital, Beijing 100034, China.
H
H
Wang
Department of Otorhinolaryngology- Head and Neck Surgery, Peking University First Hospital, Beijing 100034, China.
Q G
QG
Wang
D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D002908:Chronic Disease; D015521:Ethmoid Sinusitis / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D005151:Facial Injuries / Q000150:complications; D005260:Female; D006801:Humans; D007121:Immunocompetence; D000072742:Invasive Fungal Infections / Q000175:diagnosis* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D015523:Maxillary Sinusitis / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D011184:Postoperative Period; D012189:Retrospective Studies; D012220:Rhinitis / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents; D000935:Antifungal Agents