Rhino-orbital Aspergillosis: Changing Trends in the Management?

Abstract

Abstract Purpose To analyze the results of oral voriconazole following optimum management protocol for invasive sino-orbital aspergillosis. Methods It was a prospective study wherein all immunocompetent cases with a final histopathological diagnosis of invasive sino-orbital aspergillosis were included from a period between Jan 2007 till Dec 2009. All cases were evaluated clinically and radiologically for the condition and were classified into four groups on clinical and radiological basis. All cases were subjected to endonasal endoscopic biopsy and were subjected as per the optimum management protocol. These were then followed up for a period ranging from 6 months to 3 years clinically, endoscopically and radiologically. Results There were 15 cases enrolled for the study. There were 10 males and 5 females with age ranging from 14 to 43 years. The most common sign was proptosis. The cases in each group were subjected to the treatment protocol decided for the group. Residual disease was seen in 2 cases (13.34%) and recurrence was seen in 1 case (6.67%). One patient (6.67%) died of disease in our series. Conclusion Invasive sino-orbital aspergillosis is associated with significant morbidity and mortality. In our study, voriconazole was found to drastically improve the outcome of sino-orbital aspergillosis.