Endoscopic Surgery Outcomes in Patients With Rhino-Orbito-Sinusal Mucormycosis
Abstract
The aim of this study is to evaluate the response to endoscopic treatment and treatment outcomes in patients with rhino-orbito-sinusal mucormycosis. In this descriptive cross-sectional study, 19 patients with rhino-orbito-sinusal mucormycosis were involved. Data such as age, gender, the 6-month survival rate of the patients, type of underlying disease, site of involvement, number of endoscopic procedures, history of exenterating of the eye, type of received systemic treatments, and the time interval between the onset of symptoms and the start of treatment were recorded and analyzed. The 6-month outcome analysis showed that 10 out of 19 patients (58.8%) survived. The results also revealed no significant difference in the 6-month survival rate according to parameters such as gender, underlying disease (57.9% of the patients had diabetes and 42.1% had cancer), age, delay in surgery, site of involvement, and the number of surgeries (P>0.05). However, there was a significant difference in the 6-month survival rates of patients with respect to exenterating of the eye (P<0.05). According to our results, uncontrolled diabetes is the most common underlying cause of rhino-orbito-sinusal mucormycosis. It also seems that exenterating of the eye affects the survival rate of patients. This study suggests that timely and early diagnosis as well as correct treatment, endoscopic procedure, if possible, play an important role in the prognosis of the disease and can greatly reduce the mortality rate.
2. Mondy KE, Haughey B, Custer PL, Wippold FJ, Ritchie DJ, Mundy LM. Rhinocerebral mucormycosis in the era of lipid‐based amphotericin B: case report and literature review. Pharmacotherapy 2002;22:519-262
3. Berjis N, Hashemi SM, Sanei MH, Baseer HRG. Mucormycosis of Subglote and Trachea; A Case Report. J Isfahan Med Sch 2011;282
4. Spellberg B, Edwards J, Ibrahim A. Novel perspectives on mucormycosis: pathophysiology, presentation, and management. Clin Microbiol Rev 2005;18:556-692
5. Hammond SP, Bialek R, Milner DA, Petschnigg EM, Baden LR, Marty FM. Molecular methods to improve diagnosis and identification of mucormycosis. J Clin Microbiol 2011;49:2151-32
6. Volkenstein S, Unkel C, Neumann A, Sudhoff H, Dermoumi H, Jahnke K, et al. Mucormycosis in paranasal sinuses. HNO 2009;57:797-8032
7. El-Naaj IA, Leiser Y, Wolff A, Peled M. The surgical management of rhinocerebral mucormycosis. J Craniomaxillofac Surg 2013;41:291-52
8. Golshiri Isfahani A, Shabani Z, Lori Gooini F, Mokhtaree M. Nasal and paranasal sinus mucormycosis, Endoscopic surgery with protection of vital organs function. J Rafsanjan Univ Med Sci 2009;8:149-562
9. Saedi B, Sadeghi M, Seilani P. Endoscopic management of rhinocerebral mucormycosis with topical and intravenous amphotericin B. J Laryngol Otol 2011;125:807-102
10. Singh I, Gupta V, Gupta SK, Goyal S, Kumar M, Singh A. Our experience in endoscopic management of mucormycosis: a case series and review of literature. Int J Otorhinolaryngol Head Neck Surg 2017;3:4652
11. Bailey BJ, Johnson JT, Newlands SD. Head & neck surgery—otolaryngology. United States: Lippincott Williams & Wilkins; 20062
12. Bennett JE, Dolin R, Blaser MJ. Mandell, douglas, and bennett's principles and practice of infectious diseases: 2-volume set. Amsterdam: Elsevier Health Sciences; 20142
13. Lin SY, Lu PL, Tsai KB, Lin CY, Lin WR, Chen TC, et al. A mucormycosis case in a cirrhotic patient successfully treated with posaconazole and review of published literature. Mycopathologia 2012;174:499-5042
14. Ogawa T, Takezawa K, Tojima I, Shibayama M, Kouzaki H, Ishida M, et al. Successful treatment of rhino-orbital mucormycosis by a new combination therapy with liposomal amphotericin B and micafungin. Auris Nasus Larynx 2012;39:224-82
15. Tavanaee Sani A, Fata AM, Arian M. Presenting features and outcome of rhino-orbital-cerebral mucormycosis in two referral center in Mashhad. TUMJ 2014;72:46-512
16. Mohammadi S, Daneshi A, Javadi M. Orbitorhinocereberal mucormycosis: report of 9 cases. Razi J Med Sci (RJMS) 2002;8:397-4072
17. Pinto ME, Manrique HA, Guevara X, Acosta M, Villena JE, Solís J. Hyperglycemic hyperosmolar state and rhino-orbital mucormycosis. Diabetes Res Clin Pract 2011;91:e37-e92
18. Bakhshaee M, Bojdi A, Allahyari A, Majidi MR, Tavakol S, Najafzadeh MJ, et al. Acute invasive fungal rhinosinusitis: our experience with 18 cases. Eur Arch Otorhinolaryngol 2016;273:4281-72
19. Kashkouli MB, Abdolalizadeh P, Oghazian M, Hadi Y, Karimi N, Ghazizadeh M. Outcomes and factors affecting them in patients with rhino-orbito-cerebral mucormycosis. Br J Ophthalmol 2019;103:1460-52
20. Turner JH, Soudry E, Nayak JV, Hwang PH. Survival outcomes in acute invasive fungal sinusitis: a systematic review and quantitative synthesis of published evidence. Laryngoscope 2013;123:1112-82
21. Fata A, Nouri M. Another look at the cases of Mucormycosis at Emam Reza hospital. Med J Mashad Univ Med Sci 2006;49:209-162
22. Khodabakhshi B, Tafreshi M, Golsha R. Rhinocerebral Mucormycosis: A Series of Six cases in Gorgan. J Mazandaran Univ Med Sci 2015;25:236-432
23. Jeong W, Keighley C, Wolfe R, Lee WL, Slavin MA, Kong DCM, et al. The epidemiology and clinical manifestations of mucormycosis: a systematic review and meta-analysis of case reports. Clin Microbiol Infect 2019;25:26-342
24. Spellberg B, Ibrahim AS. Recent Advances in the Treatment of Mucormycosis. Curr Infect Dis Rep 2010;12:423-9.
25. Ochi JW, Harris JP, Feldman JI, Press GA. Rhinocerebral mucormycosis: Results of aggressive surgical debridement and amphotericin B. Laryngoscope 1988;98:1339-42.
| Files | ||
| Issue | Vol 59, No 9 (2021) | |
| Section | Articles | |
| DOI | https://doi.org/10.18502/acta.v59i9.7557 | |
| Keywords | ||
| Mucormycosis Endoscopy Site of involvement Exenterating | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
