Treatment of Paranasal Sinus Indolent Mucormycosis
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Background and Objectives: Mucormycosis of the nasal cavity and paranasal sinuses is a rare but highly aggressive especially in patients with diabetes or immunosuppressed patients. However, chronic non invastive type of mucormycosis can be observed in immunocompetent patients. In this study, we investigated indolent mucormycosis cases and assessed the clinical and radiological outcomes of indolent mucormycosis of paranasal sinus in healthy patients treated by endoscopic sinus surgery (ESS) alone. Materials and Methods: A retrospective chart analysis of 9 patients with the diagnosis of indolent mucormycosis of paranasal sinus and treated by ESS between 2007 and 2017 was performed. The data were collected from the medical records: age, sex, clinical presentations, pre- and postoperative endoscopic findings, underyling diseases, pathology, pre- and postoperative radiological findings. Radiologic images were reviewd to assess the involved side and sinus, bony sinus wall changes. Results: The histopathologic findings revealed mucormycosis with broad, non-septated, right-angled hyphae. Although the diagnosis of mucormycosis, the patients were not any antifungal agents after surgery. There was no disease progression and recurrence. Conclusion: In the case of paranasal sinus mucormycosis, ESS alone is thought to be sufficient to the treatment for indolent cases in immunocompetent patients without evidence of preoperative computed tomography and endoscopic findings of invasion and antifungal treatment may not be necessary.
Abstract
Background and Objectives: Mucormycosis of the nasal cavity and paranasal sinuses is a rare but highly aggressive especially in patients with diabetes or immunosuppressed patients. However, chronic non invastive type of mucormycosis can be observed in immunocompetent patients. In this study, we investigated indolent mucormycosis cases and assessed the clinical and radiological outcomes of indolent mucormycosis of paranasal sinus in healthy patients treated by endoscopic sinus surgery (ESS) alone. Materials and Methods: A retrospective chart analysis of 9 patients with the diagnosis of indolent mucormycosis of paranasal sinus and treated by ESS between 2007 and 2017 was performed. The data were collected from the medical records: age, sex, clinical presentations, pre- and postoperative endoscopic findings, underyling diseases, pathology, pre- and postoperative radiological findings. Radiologic images were reviewd to assess the involved side and sinus, bony sinus wall changes. Results: The histopathologic findings revealed mucormycosis with broad, non-septated, right-angled hyphae. Although the diagnosis of mucormycosis, the patients were not any antifungal agents after surgery. There was no disease progression and recurrence. Conclusion: In the case of paranasal sinus mucormycosis, ESS alone is thought to be sufficient to the treatment for indolent cases in immunocompetent patients without evidence of preoperative computed tomography and endoscopic findings of invasion and antifungal treatment may not be necessary.
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