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ORIGINAL ARTICLE
Year : 2019  |  Volume : 32  |  Issue : 2  |  Page : 703-711

Assessment of prognostic factors in patients diagnosed with acute invasive fungal rhinosinusitis in Egypt


Otorhinolaryngology Department, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt

Correspondence Address:
Ahmed M Basha
Otorhinolaryngology Department, Faculty of Medicine, Menoufia University, Shebeen El-Kom
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mmj.mmj_804_17

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Objective To evaluate the prognostic factors in patients with invasive fungal rhinosinusitis and their effects on disease outcome. Background Invasive fungal sinusitis is a fatal disease and its relative rarity has made precise identification of treatment protocols and prognostic factors difficult. Patients and methods Twenty patients diagnosed with invasive fungal sinusitis were recruited for a descriptive study. All patients were treated with antifungal drugs with proper control of their underlying diseases. Surgical debridement of necrotic and gangrenous tissue was performed in 15 patients. We divided the patients into two groups (surviving and nonsurviving). Both the groups were compared regarding the suggested prognostic factors such as the timing of presentation, the extent of gangrene at the time of presentation, state of the underlying disease, surgical treatment, and the involvement of other nearby structures. Results The overall survival rate was 45%. There was a significant difference between both groups regarding the control of original disease (P = 0.0001). There was a significant difference between both groups regarding neurological deficit (P = 0.0001) as the intracranial involvement lowered survival outcome. There was a significant difference between both groups regarding the timing of presentation (P = 0.010) with early presentation improving the survival outcome. There was a significant difference between both groups regarding the extent of gangrene (P = 0.028) with extensive gangrene at the time of presentation lowering the survival outcome. Conclusion Patients with early presentation and good control of underlying diseases had better survival outcomes. Extensive surgical debridement offered better results, but the improvement was not to the level of statistical significance. However, patients with extensive gangrene and intracranial involvement generally had worse survival outcomes; therefore, these conditions were considered negative prognostic factors.


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