Endoscopic surgery for mycotic and chronic recurring sinusitis

The Annals of Otology, Rhinology & Laryngology. Supplement
H Stammberger

Abstract

Chronic sinusitis and its complications are often caused or perpetuated by fungi. In Europe and North America Aspergillus species are the most common contaminants of the sinuses, with relatively few cases of mycoses caused by Mucor, Candida, Penicillium, Cladosporium, and Fusarium reported in the literature. Although Aspergillus and Mucor are mainly saprophytic, they may cause severe, potentially lethal complications. Consequently, therapy should include complete removal of the mycotic masses and prevention of reinfection. In nearly all cases in our experience, fungal diseases of the maxillary sinuses are secondary diseases, the pathologic conditions for which are created by chronic recurring sinusitis. Nasal endoscopy has shown that in most cases of recurring sinusitis, infection spreads from the nose into the larger sinuses, mostly from an infected anterior ethmoid. Maxillary and frontal sinuses are fully dependent on the pathophysiologic conditions in the anterior ethmoid because their ventilation and drainage pass through its complicated system of fissures and clefts into the middle nasal meatus. Endoscopic endonasal surgery of the diseased ethmoid is therefore an important element in our treatment schedule. Stenotic and/or...Continue Reading

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H Stammberger
European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
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