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FUNGAL INFECTIONS OF PARANASAL SINUSES
PARANAZAL SİNÜSLERİN FUNGAL ENFEKSİYONLARI
K.B.B. ve Baş Boyun Cerrahisi Dergisi, 1998; 6(2): 60-65
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Fungal infections can be mainly grouped into four. Invasive forms are; acute sinusitis (fulminant), chronic sinusitis (İndolent), whereas non-invasive forms are; mycetoma and allergic fungal sinusitis. From December 1993 to December 1997, 27 fungal sinusitis cases, 22 of which were noninvasive forms, and 5 of which were invasive forms were treated and are presented in this study. When we classified the patients with fungal sinusitis, 11 were diagnosed with mycetoma, 9 with allergic fungal sinusitis, 3 with acute fulminant sinusitis and 2 with chronic indolent sinusitis, while 2 patients were not included to our four groups of sinusitis. In all mycetoma cases the active agent was aspergillus. Patients with non invasive forms of sinusitis were all treated with endoscopic sinus surgery. 2 of the patients with Invasive forms of sinusitis were performed maxillectomy and they were administered Amphotericin -B. With a men follow up of 18 months, only three recurrences were seen. The infection recurred in 2 patients with allergic fungal sinusitis and l patient with chronic invasive sinusitis. However, 2 patients with acute fulminant invasive sinusitis died before they wereadministered Amphotericin -B. With a men follow up of 18 months, only three recurrences were seen. The infectionrecurred in 2 patients with allergic fungal sinusitis and l patient with chronic invasive sinusitis. However, 2 patients with acute fulminant invasive sinusitis died before they were operated on, and l patient died postoperatively.
ÖZET
Fungal sinüzitleri başlıca 4 grup altında toplayabiliriz. İnvaziv formlar: 1-Akut (Fulminan) 2-Kronik (İndolent) Non-invaziv formlar ise 3-Mycetoma ve 4- Allerjik fungal sinüzitlerdir. Aralık 1993-Aralık 1997 tarihleri arasında kronik sinüzit nedeniyle endokkopik sinüs cerrahisi uygulanan 275 hastada, histolojik, mikolojik ve immünolojik incelemeler ile fungal sinüzit araştırılmış ve toplam 27 olguya fungal sinüzit tanısı konmuştur. Fungal sinüzitli hastaların sınıflaması yapıldığında; 11 mycetoma, 9 allerjik fungal sinüzit, 3 akut fulminan ve 2 kronik indolent tanısı almış, 2 hasta ise 4 fungal sinüzit grubu içine alınamamıştır. Mycetomaların hepsinde etken aspergillustur. İkinci sıklıkta görülen fungus penicilium olmuştur. Non-invaziv formların hepsi endoskopik sinüs cerrahisi ile tedavi edilmiştir. İnvaziv formlardan iki tanesine maksillektomi yapılmış ve Amfoterisin-B uygulanmıştır. Ortalama 18 aylık takip periyodu içinde, allerjik fungal sinüzitli 2 hastada ve invaziv sinüzitli l hastada rekürrens saptanmıştır. Akut fulminan invaziv sinüzitli 2 hasta cerrahi müdahale yapılamadan l hasta ise operasyondan 5 ay sonra ex olmuştur.