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鼻-鼻窦毛霉菌病的预后评估

Prognostication of Sino-Nasal Mucormycosis.

作者信息

Sagar Prem, Mehmi Namrita, Kanodia Anupam, Jaiswal Avinash Shekhar, Kumar Rajeev, Singh Chirom Amit, Kumar Rakesh, Thakar Alok

机构信息

Department of Otolaryngology & Head Neck Surgery, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Iran J Otorhinolaryngol. 2022 Jul;34(123):157-164. doi: 10.22038/IJORL.2022.58523.3021.

Abstract

INTRODUCTION

For the purpose of prognostication of sinonasal mucormycosis, a detailed analysis of the clinical, diagnostic, therapeutic and outcome parameters has been contemplated.

MATERIALS AND METHODS

Retrospectively data was collected for all patients of sinonasal mucormycosis managed in a tertiary care hospital in last 5years.

RESULTS

Diabetes was the commonest comorbidity among total of 52 cases. Disease extent-wise, 16, 23 and 13 patients had sino-nasal (SN), rhino-orbital (RO) and rhino-orbito-cerebral (ROC) mucormycosis respectively. Median cumulative Amphotericin-B administered was 3.5gms and 94.2% of cases underwent surgical debridement depending on the disease extent. With a median follow-up of 18months, 67% of the patients are alive and disease free, 2% are under treatment and 29% of patients have expired. The mortality rate was 12.5% in SN, 30.5% in RO and 38.5% in ROC mucormycosis. Palatal and orbital involvement is associated with statistically significant mortality risk at one month.

CONCLUSIONS

Mortality rate in sino-nasal mucormycosis can be significantly curtailed with prompt control of underlying comorbidity, aggressive medical and adequate surgical management.

摘要

引言

为了对鼻窦毛霉菌病进行预后评估,已考虑对临床、诊断、治疗和结局参数进行详细分析。

材料与方法

回顾性收集过去5年在一家三级护理医院接受治疗的所有鼻窦毛霉菌病患者的数据。

结果

在总共52例病例中,糖尿病是最常见的合并症。按疾病范围划分,分别有16例、23例和13例患者患有鼻窦(SN)、鼻眶(RO)和鼻眶脑(ROC)毛霉菌病。两性霉素B的累计给药中位数为3.5克,94.2%的病例根据疾病范围接受了手术清创。中位随访18个月,67%的患者存活且无疾病,2%的患者正在接受治疗,29%的患者已死亡。鼻窦毛霉菌病的死亡率在SN为12.5%,在RO为30.5%,在ROC为38.5%。腭部和眼眶受累在1个月时与具有统计学意义的死亡风险相关。

结论

通过及时控制潜在合并症、积极的药物治疗和充分的手术管理,可显著降低鼻窦毛霉菌病的死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e75a/9392998/fe8eef8179a7/ijo-34-157-g001.jpg

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