• J Laryngol Otol · Aug 2011

    Endoscopic management of rhinocerebral mucormycosis with topical and intravenous amphotericin B.

    • B Saedi, M Sadeghi, and P Seilani.
    • Otolaryngology Department, Tehran University of Medical Sciences, Tehran, Iran. saedi@tums.ac.ir
    • J Laryngol Otol. 2011 Aug 1; 125 (8): 807-10.

    ObjectiveMucormycosis is an aggressive fungal infection which may still cause fatal complications. However, the rarity of this disease has made optimal treatment a controversial issue. This study aimed to evaluate the use of topical amphotericin B in endoscopic management of rhinocerebral mucormycosis.Subjects And MethodsThirty patients with infection limited to the nose and sinuses were selected. Patients underwent endoscopic debridement of all necrotic tissue; cottonoid pledgets soaked in amphotericin B solution were then placed in the nasal cavity. Subsequently, long-term antifungal therapy was administered.ResultsThe overall survival rate was 60 per cent (18 cases); survival rates in the diabetic and malignancy groups were 70.58 and 40 per cent, respectively. Apart from predisposing factors, orbital and maxillary sinus involvement also had a significant correlation with patient outcome.ConclusionTopical use of amphotericin B combined with endoscopic surgical debridement, followed by intravenous amphotericin B treatment, may constitute acceptable management for selected patients, with less morbidity than conventional treatments.

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