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1 results

  • Endoscopic management of rhinocerebral mucormycosis with topical and intravenous amphotericin B

  • B Saedi, M Sadeghi, P Seilani
  • Journal:
    The Journal of Laryngology & Otology / Volume 125 / Issue 8 / August 2011
    Published online by Cambridge University Press:
    10 June 2011, pp. 807-810
    Print publication:
    August 2011
    • Article
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  • Objective:

    Mucormycosis is an aggressive fungal infection which may still cause fatal complications. However, the rarity of this disease has made optimal treatment a controversial issue. This study aimed to evaluate the use of topical amphotericin B in endoscopic management of rhinocerebral mucormycosis.

    Subjects and methods:

    Thirty patients with infection limited to the nose and sinuses were selected. Patients underwent endoscopic debridement of all necrotic tissue; cottonoid pledgets soaked in amphotericin B solution were then placed in the nasal cavity. Subsequently, long-term antifungal therapy was administered.

    Results:

    The overall survival rate was 60 per cent (18 cases); survival rates in the diabetic and malignancy groups were 70.58 and 40 per cent, respectively. Apart from predisposing factors, orbital and maxillary sinus involvement also had a significant correlation with patient outcome.

    Conclusion:

    Topical use of amphotericin B combined with endoscopic surgical debridement, followed by intravenous amphotericin B treatment, may constitute acceptable management for selected patients, with less morbidity than conventional treatments.