Management of frontal sinus fungal osteomyelitis in the COVID 19 era: A case series

Elsevier

Available online 31 July 2022

Journal of Cranio-Maxillofacial SurgeryAbstractAim of the study

The aim of this study was to review different approaches and outcomes in the management of post-COVID-19 frontal sinus fungal osteomyelitis.

Case series

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.

Conclusion

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.

Keywords

Invasive fungal sinusitis

Frontal sinus

Osteomyelitis

Sequestrum

COVID-19

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© 2022 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

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