Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-27T12:10:26.514Z Has data issue: false hasContentIssue false
  • English
  • Français

Advances in management of paranasal sinus aspergillosis

Published online by Cambridge University Press:  12 October 2007

A Daudia  and
N S Jones
A Daudia
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Queen's Medical Centre, University of Nottingham, Nottingham, UK
N S Jones*
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Queen's Medical Centre, University of Nottingham, Nottingham, UK
*
Address for correspondence: Professor N S Jones, Professor of Otorhinolaryngology, Department of Otolaryngology Head and Neck Surgery, Queen's Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Surgery remains the treatment of choice for mycetoma of the paranasal sinuses. Itraconazole has a useful role in reducing both the amount of surgery required and the amount of peri-operative bleeding in allergic aspergillosis, and continuing its use post-operatively for six weeks appears to reduce the recurrence rate (although a case–control study is required to validate this observation). In chronic invasive aspergillosis, itraconazole alone appears to be curative, although liver function tests should be monitored and other interactions considered. Imaging is required to monitor resolution; remineralisation occurs after approximately six months. In fulminant aspergillosis, radical surgery and amphotericin B continue to be the treatments of choice. This review discusses the management of aspergillosis of the paranasal sinuses, and in particular the role of itraconazole antifungal therapy.

Keywords

AspergillosisParanasal SinusesItraconazole
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 4 , April 2008 , pp. 331 - 335
Copyright
Copyright © JLO (1984) Limited 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Klossek, JM, Serrano, E, Peloquin, L, Percodani, J, Fontanel, JP, Pessey, JJ. Functional endoscopic sinus surgery and 109 mycetomas of the paranasal sinuses. Laryngoscope 1997;107:112–117CrossRefGoogle ScholarPubMed
2 Ferguson, BJ. Fungus balls of the paranasal sinuses. Otol Clin North Am 2000;33:389–98CrossRefGoogle ScholarPubMed
3 Kuhn, FA, Swain, R Jr. Allergic fungal sinusitis: diagnosis and treatment. Curr Opin Otol Head Neck Surg 2003;11:1–5CrossRefGoogle ScholarPubMed
4 Manning, SC, Holman, M. Further evidence of allergic patho-physiology in allergic fungal sinusitis. Laryngoscope 1998;108:1485–96CrossRefGoogle Scholar
5 Cody, DT, Neel, HB, Ferreiro, JA, Roberts, GD. Allergic fungal sinusitis: the Mayo clinic experience. Laryngoscope 1994;104:1074–83CrossRefGoogle ScholarPubMed
6 Kupferberg, SB, Bent, JP, Kuhn, FA. The prognosis of allergic fungal sinusitis. Otolaryngol Head Neck Surg 1997;117:35–41CrossRefGoogle ScholarPubMed
7 Kuhn, FA, Javer, AR. Allergic fungal sinusitis: a four year follow-up. Am J Rhinol 2000;14:149–56CrossRefGoogle ScholarPubMed
8 Schubert, MS. Allergic fungal sinusitis. Otolaryngol Clin North Am 2004;37:301–26CrossRefGoogle ScholarPubMed
9 Stevens, DA, Schwartz, HJ, Lee, JY, Moskovitz, BL, Jerome, DC, Catanzaro, A et al. A randomised trial of itraconazole in allergic bronchopulmonary aspergillosis. NEJM 2000;342:756–62CrossRefGoogle ScholarPubMed
10 Jonathon, D, Lund, V, Milroy, C. Allergic aspergillus sinusitis – an overlooked diagnosis? J Laryngol Otol 1989;103:1181–3CrossRefGoogle Scholar
11 Rains, BM 3rd, Mineck, CW. Treatment of allergic fungal sinusitis with high dose itraconazole. Am J Rhinol 2003;17:1–8CrossRefGoogle ScholarPubMed
12 Andes, D, Proctor, R, Bush, RK. Report of successful prolonged antifungal therapy for refractory allergic fungal sinusitis. Clin Infect Dis 2000;31:202–4CrossRefGoogle ScholarPubMed
13 Mabry, RL, Marple, BF, Folker, RJ. Immunotherapy in the treatment of allergic fungal sinusitis: three years experience. Otolaryngol Head Neck Surg 1998;119:648–51CrossRefGoogle ScholarPubMed
14 Ferguson, BJ. Eosinophilic mucin rhinosinusitis: a distinct clinicopathological entity. Laryngoscope 2000;110:799–813CrossRefGoogle ScholarPubMed
15 Ferguson, BJ. Categorisation of eosinophilic chronic rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg 2004;12:237–42CrossRefGoogle ScholarPubMed
16 de Carpentier, JP, Ramamurthy, L, Denning, DW, Taylor, PH. An algorithmic approach to aspergillus sinusitis. J Laryngol Otol 1994;108:314–18CrossRefGoogle ScholarPubMed
17 Clancy, CJ, Nguyen, MH. Invasive sinus aspergillosis in apparently immunocompetent hosts. J Infect Dis 1998;37:229–40Google ScholarPubMed
18 Romett, JL, Newman, RK. Aspergillosis of the nose and paranasal sinuses. Laryngoscope 1982;92:764–6CrossRefGoogle ScholarPubMed
19 deShazo, RD. Fungal sinusitis. Am J Med Sci 1998;316:39–45Google ScholarPubMed
20 Stringer, SP, Ryan, MW. Otolaryngol Clin North Am 2000;33:375–87CrossRefGoogle Scholar
21 Denning, DW, Steven, DA. Antifungal and surgical treatment of invasive aspergillosis: a review of 2121 published cases. Rev Infect Dis 1990;12:1147–201CrossRefGoogle Scholar
22 Denning, DW, Lee, JY, Hostetler, JS, Pappas, P, Kauffman, CA, Dewsnup, DH et al. NIAID mycoses study group multicenter trial of oral itraconazole therapy for invasive aspergillosis. Am J Med 1994;97:135–44CrossRefGoogle Scholar
23 Steven, DA, Lee, J. Analysis of compassionate use itraconazole therapy for invasive aspergillosis by the NIAID mycoses study group criteria. Arch Int Med 1997;157:1857–62CrossRefGoogle Scholar
24 Stevens, DA, Kan, VL, Judson, MA, Morrison, VA, Dummer, S, Denning, DW et al. Practical guidelines for diseases caused by aspergillus. Infectious Diseases Society of America. Clin Infect Dis 2000;30:696–709CrossRefGoogle ScholarPubMed
25 Rowe-Jones, JM, Freedman, AR. Adjuvant itraconazole in the treatment of destructive sphenoid aspergillosis. Rhinology 1994;34:203–7Google Scholar
26 Panda, NK, Balaji, P, Chakrabarti, A, Sharma, SC, Reddy, CE. Paranasal sinus aspergillosis: its categorisation to development protocol. Mycoses 2004;47:277–83CrossRefGoogle Scholar
27 Dhiwaker, M, Thaker, A, Bahadur, S. Invasive sino-orbital aspergillosis: surgical decisions and dilemmas. J Laryngol Otol 2003;117:280–5CrossRefGoogle Scholar
28 Browning, AC, Sim, KT, Timms, JM, Vernon, SA, McConachie, NS, Allibone, R, Jones, NS. Successful treatment of invasive cavernous sinus aspergillosis with oral itraconazole monotherapy. J Neuroophthalmol 2006;26:103–6CrossRefGoogle ScholarPubMed
29 Gillespie, MB, O'Malley, BW, Francis, HW. An approach to fulminant invasive fungal rhinosinusitis in the immunocompromised host. Arch Otolaryngol Head Neck Surg 1998;124:520–6CrossRefGoogle ScholarPubMed
30 Radner, AB, Witt, MD, Edwards, JE Jr. Acute invasive rhinocerebral zygomycosis in an otherwise healthy patient: case report and review. Clin Infect Dis 1995;20:163–6CrossRefGoogle Scholar