科研之友
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摘要
OBJECTIVE: Acute invasive fungal rhinosinusitis (AIFRS) is a serious disease with a high mortality and morbidity rate, which almost always affects immunocompromised patients and/or patients with diabetes mellitus. Our purpose was to present the diagnostic and therapeutic management and outcome of these patients.
STUDY DESIGN: Case series with chart review
SETTING: Tertiary care university hospital
SUBJECTS AND METHODS: Twenty-six patients, who were operated on because of AIFRS between September 1999 and June 2009. were retrospectively evaluated in this study. Endoscopic surgery was used in 19 patients, and open surgical debridement was performed in seven patients
RESULTS: Overall survival rate of the patients in the open surgery group (4 of 7, 57 1%) was similar to that of the endoscopically treated group (9 of 19:47 3%) Thirteen patients (50%) died of complications related to the underlying disease (9 of 13; 69 2%) and AIFRS (4 of 13, 30 7%). AIFRS-specific survival rate is 765 percent, 90 percent (9 of 10) and 57.1 percent (4 of 7) for endoscopic and open surgery groups, respectively Four patients who died had pathological diagnosis of mucormycosis (P = 0 52)
CONCLUSION: AIFRS can be successfully treated with a combination of endonasal surgical debridement and antifungal medications Endonasal approach is suitable for patients diagnosed in the early stages of the disease and provides a less traumatic option in those patients who already have a poor health status Open surgery should be preferred in the presence of intraorbital extension, palatinal, and/or intracerebral involvement Reversing the un
- 出版日期2010-11
