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Current diagnosis and treatment of rhinosinusal aspergilloma (Review)

  • Authors:
    • Daniela Vrinceanu
    • Mihai Dumitru
    • Oana Maria Patrascu
    • Adrian Costache
    • Toma Papacocea
    • Romica Cergan
  • View Affiliations / Copyright

    Affiliations: ENT Department, Bucharest Emergency University Hospital, 010271 Bucharest, Romania, Department of Pathology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Neurosurgery, ‘Sf. Pantelimon’ Hospital, 021661 Bucharest, Romania, Department of Anatomy, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
    Copyright: © Vrinceanu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 1264
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    Published online on: September 6, 2021
       https://doi.org/10.3892/etm.2021.10699
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Abstract

There are numerous types of sinusitis caused by fungal strains, some of which already colonize the nasal cavity. Mild forms present fungus balls growing inside a preexisting sinus cavity. The invasive type ranges from chronic manifestations to acute aggravated episodes. The latter scenario is encountered in cases with reduced immune responses, such as patients with diabetes, individuals receiving any form of transplant, AIDS cases and chemotherapy patients. Without the control of immunosuppression, the infection is aggravated and extends to the orbit and inside the skull base, regardless of the prompt surgical and medical treatment. This is the most common pathogenic fungus on the nasal sinuses level. It can occasionally enter the sinus cavity during dental procedures. The pathogenesis is enhanced by anaerobic conditions in poorly ventilated sinus cavities. Rhinosinusal aspergilloma has a slow, insidious evolution over months and even years. Our experience revealed the presence of both a dental problem and previous self‑administered antibiotic regimens in almost every case. The initial symptoms are common with sinusitis of dental origin, but aspergilloma should be considered when a patient with a competent immune system does not respond to standard antibiotic treatment. The final diagnosis of rhinosinusal aspergilloma is conducted on a pathology sample with silver staining. The bacteriology exam of the sinus secretion rarely reveals a fungus infection; however, as revealed in our clinical experience, there may be coinfection with other multidrug‑resistant bacteria. Surgical treatment must establish a wide exposure of the sinus cavity and correct drainage regardless of the external, combined or endoscopic approach. Early diagnosis and emergency surgical debridement along with administering systemic antifungal compounds in some cases represent the key to the successful treatment of invasive aspergilloma.
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Copy and paste a formatted citation
Spandidos Publications style
Vrinceanu D, Dumitru M, Patrascu OM, Costache A, Papacocea T and Cergan R: Current diagnosis and treatment of rhinosinusal aspergilloma (Review). Exp Ther Med 22: 1264, 2021.
APA
Vrinceanu, D., Dumitru, M., Patrascu, O.M., Costache, A., Papacocea, T., & Cergan, R. (2021). Current diagnosis and treatment of rhinosinusal aspergilloma (Review). Experimental and Therapeutic Medicine, 22, 1264. https://doi.org/10.3892/etm.2021.10699
MLA
Vrinceanu, D., Dumitru, M., Patrascu, O. M., Costache, A., Papacocea, T., Cergan, R."Current diagnosis and treatment of rhinosinusal aspergilloma (Review)". Experimental and Therapeutic Medicine 22.5 (2021): 1264.
Chicago
Vrinceanu, D., Dumitru, M., Patrascu, O. M., Costache, A., Papacocea, T., Cergan, R."Current diagnosis and treatment of rhinosinusal aspergilloma (Review)". Experimental and Therapeutic Medicine 22, no. 5 (2021): 1264. https://doi.org/10.3892/etm.2021.10699
Copy and paste a formatted citation
x
Spandidos Publications style
Vrinceanu D, Dumitru M, Patrascu OM, Costache A, Papacocea T and Cergan R: Current diagnosis and treatment of rhinosinusal aspergilloma (Review). Exp Ther Med 22: 1264, 2021.
APA
Vrinceanu, D., Dumitru, M., Patrascu, O.M., Costache, A., Papacocea, T., & Cergan, R. (2021). Current diagnosis and treatment of rhinosinusal aspergilloma (Review). Experimental and Therapeutic Medicine, 22, 1264. https://doi.org/10.3892/etm.2021.10699
MLA
Vrinceanu, D., Dumitru, M., Patrascu, O. M., Costache, A., Papacocea, T., Cergan, R."Current diagnosis and treatment of rhinosinusal aspergilloma (Review)". Experimental and Therapeutic Medicine 22.5 (2021): 1264.
Chicago
Vrinceanu, D., Dumitru, M., Patrascu, O. M., Costache, A., Papacocea, T., Cergan, R."Current diagnosis and treatment of rhinosinusal aspergilloma (Review)". Experimental and Therapeutic Medicine 22, no. 5 (2021): 1264. https://doi.org/10.3892/etm.2021.10699
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