PURPOSE OF REVIEW: To summarize diagnostic techniques for invasive fungal rhinosinusitis and provide a review of treatment options once disease has spread to the orbit. RECENT FINDINGS: Improved imaging criteria, polymerase chain reaction and other serologic tests show promise in advancing our ability to accurately diagnose invasive fungal disease. Currently, there exists three treatment options for infected orbital tissue: exenteration, conservative debridement and transcutaneous retrobulbar injection of amphotericin B. Exenteration, the most frequently reported intervention, has not been proven to enhance survival. Conservative debridement and transcutaneous retrobulbar injection of amphotericin B are increasingly considered reasonable first-line options. SUMMARY: Although investigative tools are improving, invasive fungal rhinosinusitis can still pose a diagnostic challenge. No one treatment option for the orbit has been proven superior to another. Therefore, it is justified to initiate therapy by prioritizing less morbid procedures. If deterioration is continually noted, more invasive interventions can then be employed. The treatment algorithm established at our institution is provided.
PURPOSE OF REVIEW: To summarize diagnostic techniques for invasive fungal rhinosinusitis and provide a review of treatment options once disease has spread to the orbit. RECENT FINDINGS: Improved imaging criteria, polymerase chain reaction and other serologic tests show promise in advancing our ability to accurately diagnose invasive fungal disease. Currently, there exists three treatment options for infected orbital tissue: exenteration, conservative debridement and transcutaneous retrobulbar injection of amphotericin B. Exenteration, the most frequently reported intervention, has not been proven to enhance survival. Conservative debridement and transcutaneous retrobulbar injection of amphotericin B are increasingly considered reasonable first-line options. SUMMARY: Although investigative tools are improving, invasive fungal rhinosinusitis can still pose a diagnostic challenge. No one treatment option for the orbit has been proven superior to another. Therefore, it is justified to initiate therapy by prioritizing less morbid procedures. If deterioration is continually noted, more invasive interventions can then be employed. The treatment algorithm established at our institution is provided.
Authors: Rafat Ghabrial; Arjun Ananda; Sebastiaan J van Hal; Elizabeth O Thompson; Stephen R Larsen; Peter Heydon; Ruta Gupta; Svetlana Cherepanoff; Michael Rodriguez; Gabor Michael Halmagyi Journal: Neuroophthalmology Date: 2017-11-07
Authors: Kristin E Hirabayashi; Oluwatobi O Idowu; Evan Kalin-Hajdu; Catherine E Oldenburg; Frank L Brodie; Robert C Kersten; M Reza Vagefi Journal: Ophthalmic Plast Reconstr Surg Date: 2019 Nov/Dec Impact factor: 2.011
Authors: Aaron R Kaufman; Alex B Labby; Chau Pham; Gursant S Atwal; Tatiana K Dixon; Burce Ozgen Mocan; Victoria S Lee Journal: Am J Ophthalmol Case Rep Date: 2022-02-18