Home > Journals > Italian Journal of Maxillofacial Surgery > Past Issues > Rivista Italiana di Chirurgia Maxillo-Facciale 2002 December;13(3) > Rivista Italiana di Chirurgia Maxillo-Facciale 2002 December;13(3):147-54

CURRENT ISSUE
 

ARTICLE TOOLS

Reprints

ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY

A Journal on Maxillofacial Surgery


Official Journal of the Italian Society of Maxillofacial Surgery


eTOC

 

ORIGINAL ARTICLES  


Rivista Italiana di Chirurgia Maxillo-Facciale 2002 December;13(3):147-54

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: English

Endoscopic treatment of fungal sinusitis

Politi M. 1, Costa F. 1, Polini F. 1, Robiony M. 1, Emanuelli E. 2

1 Unit of Maxillo-Facial Surgery University of Udine, Udine, Italy 2 ENT Department University of Padua, Padua, Italy


PDF  


Aim. Fungal sinus­itis ­has ­been ­seen increas­ing­ly in immu­no­com­pe­tent indi­vid­u­als. Endoscopie treat­ment ­with sur­gi­cal debride­ment is ­the treat­ment of ­choice ­after a cor­rect diag­no­sis.
Methods. We ­report 3 cas­es of fun­gal sinus­itis: 2 immu­no­com­pe­tent cas­es ­with unilat­er­al max­il­lary involve­ment ­and 1 ­non immu­no­com­pe­tent ­case ­with uni­lat­er­al max­il­lary ­and sphe­noid ­sinus involve­ment. At pres­en­ta­tion ­all of ­our ­patients ­had symp­toms of chron­ic sinus­itis refrac­to­ry to med­i­cal man­age­ment. Computerised tomog­ra­phy ­and, occa­sion­al­ly, mag­net­ic res­o­nance imag­ing ­are of ­great ­help in ­the assess­ment of ­the dis­ease. The radio­log­i­cal pres­en­ta­tion ­was ­always an het­er­o­ge­ne­ous opac­ity ­with ­microcalcifìca-tions. After ade­quate eval­u­a­tion, func­tion­al endo­scop­ie ­sinus sur­gery (­FESS) ­was per­formed to ­obtain a ­wide open­ing of ­the affect­ed ­sinus, per­mit­ting a care­ful extrac­tion of ­all fun­gal mate­ri­al. After sur­gery, ­packs ­were ­placed in ­the mid­dle mea­tus ­for 3 ­days ­and ­all ­patients ­received top­ic ster­oids ­over 4 ­weeks. Follow-up ­has ­ranged ­from 4 ­months to 1 ­year ­after sur­gery ­and ­patients ­were ­all close­ly fol­lowed post­op­er­a­tive­ly ­with seri­al endo­scop­ic exam­ina­tions.
Results. None of ­the ­patients ­required a sec­ond pro­ce­dure. Two ­patients ­had pos­i­tive fun­gal cul­ture ­for Aspergillus. None of ­the ­patients ­had evi­dence of inva­sive dis­ease ­and system­ic anti­fun­gal ther­a­py ­was ­not ­required.
Conclusion. ­FESS per­mits a ­safe extrac­tion of my­cet­o­mas by a ­wide open­ing of ­the affect­ed sinus­es asso­ciat­ed ­with a care­ful extrac­tion of ­all fun­gal mate­ri­al with­out ­any remov­al of ­sinus muco­sa.

top of page

Publication History

Cite this article as

Corresponding author e-mail