Gardner James Reed, Hunter Courtney J, Vickers Donald, King Deanne, Kanaan Alissa
Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
OTO Open. 2021 Mar 11;5(1):2473974X211002547. doi: 10.1177/2473974X211002547. eCollection 2021 Jan-Mar.
The purpose of this study is to identify perioperative independent prognostic factors that are available to the consulting team to aid in determining prognosis in patients with acute invasive fungal sinusitis.
Retrospective chart review of patients with biopsy-proven acute invasive fungal sinusitis from 2015 to 2018.
Academic tertiary care center.
Twenty-one patients were included from our single-center retrospective review. Kaplan-Meier graphs were created, and the Breslow test used to compare the curves to obtain values. A univariate Cox regression analysis was performed on the data that were significant at 3 months from diagnosis.
Twenty-one patients were included, and 17 (76%) had an underlying hematologic malignancy. Overall survival was 71% and 52% at 1 and 3 months, respectively, and 94% of patients with hematologic malignancy had an absolute neutrophil count ≤1 at diagnosis. Absolute neutrophil count values and fungal species were not associated with a difference in prognosis. Factors associated with decreased survival included current smoking and the absence of a rhinologist on the treatment team at the initial or subsequent debridement (hazard ratio, 3.03). Laboratory values such as beta-D-glucan and galactomannan were assessed in addition to disease extension at diagnosis.
This study presents a retrospective review of a single institution's experience with acute invasive fungal sinusitis. Subspecialty level of care likely improves overall survival in these patients, whereas current smoking may imply a worse prognosis.
本研究旨在确定围手术期独立预后因素，以便会诊团队用于协助判断急性侵袭性真菌性鼻窦炎患者的预后。
对2015年至2018年经活检证实为急性侵袭性真菌性鼻窦炎的患者进行回顾性病历审查。
学术性三级医疗中心。
我们的单中心回顾性研究纳入了21例患者。绘制了Kaplan-Meier曲线，并使用Breslow检验比较曲线以获得P值。对诊断后3个月时具有显著意义的数据进行单变量Cox回归分析。
纳入21例患者，其中17例（76%）有潜在血液系统恶性肿瘤。1个月和3个月时的总生存率分别为71%和52%，94%的血液系统恶性肿瘤患者诊断时绝对中性粒细胞计数≤1。绝对中性粒细胞计数值和真菌种类与预后差异无关。与生存率降低相关的因素包括当前吸烟以及在初次或后续清创时治疗团队中没有鼻科医生（风险比，3.03）。除了诊断时的疾病范围外，还评估了β-D-葡聚糖和半乳甘露聚糖等实验室值。
本研究对单一机构急性侵袭性真菌性鼻窦炎的经验进行了回顾性分析。专科护理水平可能会提高这些患者的总生存率，而当前吸烟可能意味着预后较差。
