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Invasive aspergillosis of the paranasal sinuses and the skull base

  • Rhinology
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Abstract

Invasive aspergillosis (IA) originating from the paranasal sinuses can cause an intracranial growth mainly along the skull base and larger vessels. This study reports our experience in the diagnosis and treatment of a series of patients with IA. A retrospective chart review of four patients with chronic invasive intracranial aspergillosis was performed. Clinical signs, physical examinations, radiographs, histological samples, and outcome were demonstrated. The patients demonstrated different symptoms like exophthalmus, ophthalmoplegia, loss of vision, and hypaesthesia of the ophthalmic and maxillary nerve. Computed tomography and MRI revealed extensive sino-orbital and skull base lesions. The patients were treated with aggressive endonasal debridement, intravenous antifungal agents and daily irrigations with antimycotic suspensions. Furthermore, we applied hyperbaric oxygenation. Two patients died from complications due to subarachnoidal hemorrhage and accompanied complications respectively. Despite the high mortality rate patients with an invasive aspergillosis can be effectively treated in some cases by an early and rigorous treatment schedule using all surgical and conservative therapeutic options.

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Authors and Affiliations

  1. Department of Otorhinolaryngology Head and Neck Surgery, Martin Luther University Halle-Wittenberg, Magdeburger Str. 12, Halle/Saale, 06097, Germany

    Stephan Knipping

  2. Pathological Institute, Martin Luther University Halle-Wittenberg, Magdeburger Str. 12, Halle/Saale, 06097, Germany

    Hans Juergen Holzhausen

  3. Institute of Diagnostic Radiology, Martin Luther University Halle-Wittenberg, Magdeburger Str. 12, Halle/Saale, 06097, Germany

    Sabrina Koesling

  4. Department of Otorhinolaryngology Head and Neck Surgery, University of Saarland, Homburg, Germany

    Marc Bloching

Authors
  1. Stephan Knipping
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  2. Hans Juergen Holzhausen
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  3. Sabrina Koesling
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  4. Marc Bloching
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Corresponding author

Correspondence to Stephan Knipping.

Additional information

This study was presented at the Annual Meeting of the American Academy of Otolaryngology- Head and Neck Surgery Foundation, 17–20 September 2006, Toronto, ON, Canada.

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Knipping, S., Holzhausen, H.J., Koesling, S. et al. Invasive aspergillosis of the paranasal sinuses and the skull base. Eur Arch Otorhinolaryngol 264, 1163–1169 (2007). https://doi.org/10.1007/s00405-007-0336-7

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  • DOI: https://doi.org/10.1007/s00405-007-0336-7

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