Three Cases of Fungal Sinusitis with Orbital Complication

Moon, In Hee; Yoon, Sang Pil; Jung, Hee Sub; Chang, Chin Soon

Abstract

The most commonly involves observed in the fungal infection of sinus is the maxillary sinus, followed by ethmoid sinus. On the other hand, sphenoid sinus is only occasionally affected. In the sphenoidal fungal sinusitis, however, its complication may cause fatal outcome when the adjacent vital structures are involveed. The orbital involvement of invasive fungal sinusitis has been rarely reported, which may occur via the direct spread of invasive disease or through the communicating veins despite intact sinus walls. The invasive fungal sinusitis needs aggressive therapy, including endoscopic sinus surgery. But, when there is evidence of spread to the adjacent structure, adjuvant antifungal chemotherapy can be used. We recently experienced three cases of fungal sinusitis with orbital complication. The first case was limited to the left sphenoid sinus and treated with surgery. Adjuvant antifungal chemotherapy was tried but discontinued due to poor general condition. The other two cases involved the ethmoid and sphenoid sinus have been treated with surgery and adequate antifungal chemotherapy. The orbital complication in the first case was improved, but the patient died after 3 months due to poor gerneral condition. In the other two cases, patients completely recovered from fungal sinusitis and the orbital complication.