Management of frontal sinus fungal osteomyelitis in the COVID 19 era: A case series. Issue 9 (September 2022)

• Record Type: Journal Article
• Authors: Ebada, Hisham Atef; Abd El-Fattah, Ahmed Musaad; Tawfik, Ali
• Is Part Of: Journal of cranio-maxillofacial surgery. Volume 50:Issue 9(2022)
• Page Start: 692
• Page End: 698
• Publication Date: 2022-09
• Subjects: Invasive fungal sinusitis -- Frontal sinus -- Osteomyelitis -- Sequestrum -- COVID-19; Skull -- Surgery -- Periodicals; Maxilla -- Surgery -- Periodicals; Face -- Surgery -- Periodicals; Surgery, Plastic -- Periodicals; Maxilla -- surgery -- Periodicals; Face -- surgery -- Periodicals; Skull -- surgery -- Periodicals; Oral Surgical Procedures -- Periodicals; Reconstructive Surgical Procedures -- Periodicals; Surgery, Plastic -- Periodicals; Surgery, Oral -- Periodicals; Electronic journals; 617.514
• DOI: 10.1016/j.jcms.2022.07.010
• Languages: English
• ISSNs: 1010-5182

Abstract

Abstract: The aim of this study was to review different approaches and outcomes in the management of post-COVID-19 frontal sinus fungal osteomyelitis. The study included 19 patients with frontal sinus fungal osteomyelitis. The main line of treatment was surgical debridement (sequestrectomy). Approaches included combined external and endoscopic approaches (n = 15) and pure endoscopic approaches (n = 4) according to the extent and accessibility of the sequestrum. Postoperative healing was satisfactory in all patients. All patients returned to their normal daily activity within 4–6 weeks, without residual or recurrent frontal sinus infection, osteomyelitis or need for revision procedures. Within the limitation of this case series, it seems that there is no need to adopt a new therapy regimen for treatment of frontal sinus fungal osteomyelitis because the conventional and well-known treatment approach combining surgery and antifungal drugs seems to work well. However, early, and adequate debridement and sequestrectomy is crucial. Furthermore, an open approach may be required according to the extent of osteomyelitis.