|
Neurology India
Medknow Publications on behalf of the Neurological Society of India
ISSN: 0028-3886 EISSN: 0028-3886
Vol. 58, No. 2, 2010, pp. 270-276
|
Bioline Code: ni10068
Full paper language: English
Document type: Research Article
Document available free of charge
|
|
Neurology India, Vol. 58, No. 2, 2010, pp. 270-276
en |
Invasive rhino-cerebral fungal granuloma
Selvam, Muralimohan; Pande, Anil; Chakravarthy, Vasudevan M. & Ramamurthi, Ravi
Abstract
Background: Increased incidence of fungal infection has been reported globally in the recent years. Fungal infection of the central nervous system remains one of the most difficult diseases to treat and requires multi-modality intensive therapeutic strategies. Materials and Methods: Retrospective analysis of case records of patients with confirmed skull base fungal granuloma treated at a tertiary hospital between 1988-2008. An attempt was made to stage the extent of skull base fungal granuloma based on neuroimaging, operative findings and course of the disease on serial follow-up. Results: Thirty-three patients with skull base fungal granuloma were treated surgically during the study period. The mean age at presentation was 33.2 years and diabetes was a major predisposing factor. Eight patients expired in the first two months following surgical intervention due to flare-up of the disease. Eighteen patients who underwent grossly total excision had a mean progression-free survival (PFS) of 43 months and seven patients with subtotal excision had a mean PFS of 23 months. Better survival probability was noted in those patients who underwent total excision at surgery and received complete course of amphotericin. Conclusion: Total surgical excision with complete course of antimycotic drug therapy increases PFS. A better antimycotic drug with less toxicity and high efficacy with fungicidal property can make a difference in the outcomes of the disease.
Keywords
Aspergillosis, amphotericin, mucor mycosis, paranasal sinus, rhinocerebral mycosis
|
|
© Copyright 2010 Neurology India. Alternative site location: http://www.neurologyindia.com
|
|