Invasive Fungal Diseases of the Skull Base

Sankar, M. Ravi; Mathialagan, Arulalan; Keshri, Amit; Srivastava, Arun Kumar; Jaiswal, Awadhesh Kumar; Behari, Sanjay

doi:10.1007/978-3-030-06088-6_21

Cited by 2 publications

(1 citation statement)

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“…1 Since the sinonasal cavity is closely related to the skull base and orbit, there is disease extension in these regions. 2 Over the years, it was evident that the most common pathogen causing AFIS was Mucorales species (rhino-oribitocerebral mucormycosis [ROCM]). AFIS has a poor prognosis due to the underlying immunocompromised state.…”

Section: Introductionmentioning

confidence: 99%

Changing Spectrum of Invasive Fungal Infections of the Anterior Skull Base

Bhuskute

Keshri

Seduchidambaram

et al. 2023

J Neurol Surg B Skull Base

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Objective To study the evolving pathophysiology and symptomatology of invasive fungal rhinosinusitis affecting the skull base. Design Retrospective clinical study Setting Single-Centre Materials and Methods: All cases of invasive fungal rhinosinusitis with clinico-radiological and/or operative evidence of anterior and central skull base, orbit, and orbital apex involvement with or without intracranial disease were included in the study. We assessed the risk factors such as COVID 19 infection, diabetes mellitus and radiological features and management strategy Results: There were 79 patients, of which 65.8% had skull base ROCM, and 34.2% had invasive aspergillosis. The mean duration of onset of the disease was 36.75±20.97 days in ROCM with the majority of patients (66%) presenting after 30 days of symptoms. In the Invasive aspergillosis group, the median presentation duration after symptom onset was 21 weeks. In 40.8% of patients, tissue diagnosis was unavailable, and galactomannan assay and clinico-radiological assessment were used for diagnosis. The most common area of the skull base was the pterygopalatine fossa (88.5%). The most common Neural structure involved was the pterygopalatine ganglion. Conclusion: With the increasing incidence of invasive fungal infections worldwide, particularly after the Covid- 19 pandemic, it is crucial to understand the evolving nature of this disease. ROCM, documented in the literature to cause fulminant disease, became a chronic illness, possibly due to the improvement of the patient's immunity during the disease course.

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Section: Introductionmentioning

confidence: 99%