Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Sci Rep. 2020 Feb 28;10(1):3688. doi: 10.1038/s41598-020-60719-7.
Acute invasive fungal rhinosinusitis (AIFRS) can spread beyond the sinonasal cavity. It is necessary to analyze the association between the specific site involved in the extrasinonasal area and the survival rate to predict patient prognosis. We investigated 50 patients who had extrasinonasal lesions on preoperative gadolinium (Gd)-enhanced magnetic resonance imaging (MRI) scan and underwent wide surgical resection of AIFRS. The specific sites with loss of contrast enhancement (LoCE) on Gd-enhanced MRI were analyzed for AIFRS-specific survival rate. The most common underlying disease was diabetes mellitus followed by hematological malignancy. The most common symptoms were headache and facial pain. Seven patients (14.0%) expired because of AIFRS progression. Poor prognosis was independently associated with LoCE at the skull base on preoperative MRI (HR = 35.846, P = 0.004). In patients with AIFRS extending to the extrasinonasal area, LoCE at the skull base was an independent poor prognostic factor.
急性侵袭性真菌性鼻-鼻窦炎（AIFRS）可扩散至鼻窦腔以外。有必要分析鼻窦外受累特定部位与生存率之间的关系，以预测患者的预后。我们研究了 50 名术前钆增强磁共振成像（MRI）扫描显示鼻窦外病变并接受 AIFRS 广泛手术切除的患者。对 Gd 增强 MRI 上出现对比剂丢失（LoCE）的特定部位进行分析，以评估 AIFRS 特异性生存率。最常见的潜在疾病是糖尿病，其次是血液恶性肿瘤。最常见的症状是头痛和面部疼痛。7 名患者（14.0%）因 AIFRS 进展而死亡。术前 MRI 上颅底的 LoCE 与不良预后独立相关（HR = 35.846，P = 0.004）。在 AIFRS 扩散至鼻窦外的患者中，颅底的 LoCE 是独立的不良预后因素。
