원저

비강 및 부비동 진균증의 임상적 고찰

이흥만1, 차흥억1, 이상학1, 최건1, 황순재1
Heung Man Lee1, Heung Eog Cha1, Sang Hak Lee1, Geun Choi1, Soon Jae Hwang1
Author Information & Copyright
1고려대학교 의과대학 이비인후과학교실
1Department of Otolaryngology, College of Medicine, Korea University

© Copyright 1992 The Busan, Ulsan, Gyeoungnam Branch of Korean Society of Otolaryngology-Head and Neck Surgery. This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published Online: May 31, 2020

ABSTRACT

The mycotic infections of the nose and paranasal sinus had been rare occurence about a decade before. However, with the advent of therapy with antibiotics, steroids, and chemotherapeutic agents, the incidence of the fungal infection seems to have increased recently. The disease is characterized by a wide range of initial symptoms and should be considered as a possible diagnosis in case of sinusitis refractory to routine therapy. For the diagnosis, the histopathologic study with special staining methods, such as Gomori’s methenamine silver(GMS) stain or Periodic Acid-Schiff(PAS) stain, should be performed.

We analysed the clinical history and the pathologic findings of 3 cases of aspergillosis and 7 cases of mucormycosis which were diagnosed as mycotic infection of the nose and paranasal sinus and treated between June 1984 and October 1991.

The results were as follows:

  1. The male to female ratio was 1 : 1 in total 10 cases of mycotic infection(2 : 1 in the aspergillosis and 1 : 1.3 in the mucormycosis) and the mean age was 43.8 years.

  2. There were no underlying disease in both aspergillosis and mucormycosis except in 1 case of aspergillosis with acute myelocytic leukemia.

  3. The intervals from the first symptom to hospital visit were as follows: 6 cases over 1 year, 3 cases within 3 months and 1 case at 4 months.

  4. Most common clinical manifestations were purulent rhinorhea, postnasal drip, nasal obstruction, headache and foul odor.

  5. Abnormal radiologic findings were clouding of the involved sinuses and bony destruction in 1 case.

  6. A saddle nose deformity occurred in a case of aspergillosis with acute myelocytic leukemia, which developed in the nasal cavity in spite of the treatment with Amphotericin B.

  7. In one case of aspergillosis and 6 cases of mucormycosis which were found incidentally following Caldwell-Luc’s operation, the follow-up results were good.

Keywords: Nose; Paranasal sinus; Fungal infectioni Aspergillosis, Mucormysocis)