Evaluation of pre-intraoperative findings and surgical outcomes in patients with Sinonasal Mucormycosis

Introduction: Mucormycosis is a rare but rapidly fatal fungal infection almost always seen in patients with immune deficiency. The aim of our study is to evaluate the effect of pre-intraoperative findings on clinical course of the disease/ postoperative survival and to present our approach Acute Invasive Fungal Rhinosinusitis (AIFRS).

Material and methods: The data of patients who underwent endonasal endoscopic surgery due to AIFRS during past 3 years were analyzed retrospectively. Demographics, test results, endoscopy findings, imagings, operation reports and patient follow-up forms were analyzed retrospectively.

Results: Thirtyfive (64.8%) of the patients operated on with a pre-diagnosis of mucormycosis were male and 19 (35.2%) were female. Pathology of 30 (55.6%) of the total 54 patients came as mucormycosis. Fever was the most common symptom (81.5% )followed by recently started nasal obstruction (44.4%). In about half of the patients, no lesion was observed during the examination. All the patients had surgical resection and Amphotericin B treatment. 72.2% of the patients were operated within the first 24 hours, 13% of the patients were operated within 24-48 hour, while 14.8% of the patients were operated after 48 hours from presentation. 50% of recurrences occurred among patients who underwent surgery later than 48 hours from presentation.

Conclusion / Discussion: In management of AIFR due to mucormycosis ; high suspicion in patients with high infection risk and early diagnosis is important to be able to eliminate the infection by endonasal endoscopic approach in a minimally invasive way. Despite no visible lesions on endoscopy high risk patients with symptoms should be assessed with radiological imaging and closely followed up for timely surgical intervention.

.The authors declare that there is no conflict of interest