Kulkarni N S, Bhide A R, Wadia R S
Department of ENT and Neurology, Ruby Hall Clinic, Pune, India.
Indian J Otolaryngol Head Neck Surg. 2005 Apr;57(2):121-4. doi: 10.1007/BF02907665.
The study was done in two parts:Analysis of CT scan findings of 17 cases of mucormycosis to determine paranasal sinus, orbital and intra-cranial involvement.Cadaveric dissections of the ethmoid complex anatomy to correlate the probable mode of spread. Ethmoidal sinus was found to be the most commonly involved. The disease probably appears first here, spreads to orbit through the lamina papyracea and then through the retro-orbital region, intra-cranially. Our aim would be to diagnose the disease at the stage of ethmoid involvement. In immuno-compromised patients, if headache, peri- or retro-orbital pain or blood stained nasal discharge occur; a CT scan of the paranasal sinuses and a nasal endoscopy with biopsy from anterior ethmoids, if this area shows pathology then CT scan must be performed. If this is positive for mucormycosis, surgical debridement of the involved sinuses is to be done and Amphotericin B as intra-venous infusion and treatment of underlying condition is started.
分析17例毛霉菌病的CT扫描结果，以确定鼻窦、眼眶和颅内受累情况；对筛窦复合体进行尸体解剖，以关联可能的传播方式。发现筛窦是最常受累的部位。疾病可能首先在此处出现，通过纸样板蔓延至眼眶，然后经眶后区域蔓延至颅内。我们的目标是在筛窦受累阶段诊断出该疾病。对于免疫功能低下的患者，如果出现头痛、眶周或眶后疼痛或血性鼻分泌物，应进行鼻窦CT扫描以及鼻内镜检查并从前筛窦取活检，如果该区域显示有病变，则必须进行CT扫描。如果毛霉菌病检测呈阳性，应进行受累鼻窦的手术清创，并开始静脉输注两性霉素B以及治疗基础疾病。
