Journal of Rafsanjan University of Medical Sciences

  Nasal and Paranasal Sinus Mucormycosis, Endoscopic Surgery with Protection of Vital Organs Function

  A. Golshiri Isfahani [1] , Z. Shabani [2] , F. Lori Gooini [3] , M.R. Mokhtaree [4]

  Received: 25/09/07 Sent for Revision: 15/09/08 Received Revised Manuscript: 30/04/09 Accepted: 09/05/09

  Background and Objectives: Mucormycosis is a rare but often fatal disease caused by a fungus from the group of Mucorales. It most commonly affects the nose and brain. The aim of this report is the emphasis to quick recognition and treatment of some opportunistic infections in patients with diabetes or suppressed immune systems and emphasis on surgery with protection of vital organs functions and limitations of some endoscopes in the nasal surgery.

  Case Report: This report presents a 76-year old diabetic female with severe headache, facial pain and hearing loss and recognition of paranasal sinus mucormycosis who was hospitalized in Rafsanjan Moradi Hospital. After two successive surgeries, (endoscopic surgery and medial maxillectomy) and medical therapy with Amphotricin B after 45 days was recovered.

  Conclusion: In the patients who are referred with headache or facial pain, exact examination and history-taking about underlying disease and immunosuppressive drugs is necessary. Protection of vital organs in the surgery for removeal of necrotic and infected tissues and endoscopic surgery with Caldwell-Luc procedure for better access to anterior wall of maxillary sinus must be considered.

  Key words: Mucormycosis, Sinusitis, Endoscopic Surgery

  [1] - Asistant Prof, Dept. of Surgry, Otorhinolaryngologist, University of Medical Sciences, Rafsanjan, Iran

  (Corresponding Author) Tel: (0391)5230080, Fax: (0391) 5225800, E-mail: a_golshiri@rums.ac.ir

  [2] - Asistant Prof, Dept.of Internal Medicine, Master of Infectious Disease, University of Medical Sciences, Rafsanjan, Iran

  [3] - Asistant Prof, Dept. of Surgry, Otorhinolaryngologist, University of Medical Sciences, Rafsanjan, Iran

  [4] - BSc, in Nursing, Moradi Hospital, University of Medical Sciences, Rafsanjan, Iran