Septal Defect Research Articles

Recurrent mitral regurgitation after repair of Barlow's disease in a single-center retrospective cohort study.

Barlow's disease (BD) is a common etiology of degenerative mitral valve (MV) disease, often causing significant mitral regurgitation (MR). The pathology of BD is challenging for surgeons performing MV repair (MVR). However, most MVR effectiveness studies have been based on survival and risk of reoperation. The aim of this study was to analyze the safety, efficacy, and durability of MVR in patients with BD and to identify factors that influence recurrent MR. We retrospectively analyzed the clinical outcomes of 274 patients undergoing MVR for BD at a tertiary hospital (Guangdong People's Hospital, Guangzhou, China) between January 2010 and June 2022. To analyze the results of MVR and identify the risk factors for MR recurrence, we defined two groups: a total of 240 patients with MR grade <2+ (group A) and a total of 34 patients who had recurrent MR after MVR (group B; the patients with MR ≥2+). All patients were operated on using standard repair techniques. Recurrent MR was the primary outcome. Secondary outcomes were death and reoperation after MVR. Patients were followed up until March 2023. Patients were followed up by clinic visits, telephone calls, and postal or electronic questionnaires. The median [range] patient age was 46.00 [16-75] years and 186 (67.9%) patients were male. Concomitant procedures were performed in 123 patients: tricuspid valve repair 71 (25.9%), maze or pulmonary vein isolation (PVI) 12 (4.4%), atrial septal defect (ASD) repair 3 (1.1%), and left atrial appendage (LAA) closure 28 (10.2%). Hospital mortality was 0.4%. Long-term complications included radiofrequency ablation in 7 patients (2.6%), pacemaker implantation in 1 patient (0.4%), and stroke in 3 patients (1.1%). The median follow-up was 3.28 (range, 0-12.39) years. Considering the competing risk of mortality, the cumulative incidence of MR progression 2+ or more grades was 2.6%, 5.9%, 14.5%, and 27.7% at 1 month, 1, 5, and 10 years, respectively. Overall survival at 1, 5, and 10 years was 99.3%, 98.6%, and 98.6%, respectively. The immediate postoperative MR area [hazard ratio (HR) =1.723; 95% confidence interval (CI): 1.051-2.824; P=0.031], postoperative left ventricular end-diastolic dimension (LVEDD) (HR =1.149; 95% CI: 1.016-1.300; P=0.027), and postoperative MR grade {HR = Exp[4.500 - 0.544 × ln(t + 20)]; P=0.008} were associated with an increased risk of MR recurrence, whereas a higher left ventricular ejection fraction (LVEF) (HR =0.931; 95% CI: 0.868-0.999; P=0.049) was associated with a decreased risk. MVR in patients with BD can be performed with low mortality and complications and is associated with superior long-term outcomes. However, MVR was associated with a certain risk of MR recurrence, especially in those with high postoperative LVEDD, residual MR >1+, and decreased postoperative LVEF. We recommend MVR for patients with BD, especially for those with early-stage disease. However, future randomized controlled trials are needed to confirm this.

Delayed iatrogenic atrial septal defect after implantation of a bicaval prosthesis device for the treatment of tricuspid regurgitation.

We present the case of a 71-year-old woman with rheumatic valvular disease who underwent mitro-aortic mechanical valve replacement and tricuspid annuloplasty in 2011. She required a dual-chamber pacemaker in 2012 and developed severe tricuspid regurgitation (TR), leading to percutaneous annuloplasty with Cardioband® system in 2021.

Intracardiac vs transesophageal echocardiography for left atrial appendage occlusion: An updated systematic review and meta-analysis

BackgroundMultiple studies continue to evaluate the use of intracardiac echocardiography (ICE) and transesophageal echocardiography (TEE) for guiding left atrial appendage occlusion (LAAO). ObjectiveThe purpose of this study was to conduct an updated meta-analysis comparing the effectiveness and safety outcomes of both imaging modalities. MethodsPubMed, Cochrane, and Embase were searched for studies comparing ICE vs TEE to guide LAAO. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a random-effects model. The primary effectiveness endpoint was procedural success. The primary safety endpoint included the overall complications rate. Additional safety outcomes were assessed as secondary endpoints. Subgroup analysis of primary endpoints was conducted according to device type (Amulet, LAmbre, Watchman, Watchman FLX) and study region (American, Asia, Europe). R Version 4.3.1 was used for all statistical analyses. ResultsOur meta-analysis included 19 observational studies encompassing 42,474 patients, of whom 4415 (10.4%) underwent ICE-guided LAAO. Compared with TEE, ICE was associated with a marginally higher procedural success (OR 1.33; 95% CI 1.01–1.76; P = .04; I2 = 0%). There was no significant difference in the overall complications rate (OR 1.02; 95% CI 0.77–1.36; P = .89; I2 = 5%). However, ICE showed higher rates of pericardial effusion (OR 2.11; 95% CI 1.47–3.03; P <.001; I2 = 0%) and residual iatrogenic atrial septal defect (iASD) (OR 1.52; 95% CI 1.15–2.03; P <.004; I2 = 0%). Subgroup analysis revealed variations in procedural success within the ICE group across study regions (P = .02). ConclusionIn this updated meta-analysis, the increasing adoption of ICE-guided LAAO demonstrated higher procedural success rates compared to TEE, although with limited statistical significance. Overall complication rates were similar; however, ICE showed higher rates of pericardial effusion and residual iASD.

Shortened Duration of Dual Anti-Platelet Therapy After Percutaneous Patent Foramen Ovale and Atrial Septal Defect Closure

Shortened Duration of Dual Anti-Platelet Therapy After Percutaneous Patent Foramen Ovale and Atrial Septal Defect Closure

Feasibility and accuracy of virtual reality for surgical and interventional planning for sinus venosus atrial septal defect repair

Feasibility and accuracy of virtual reality for surgical and interventional planning for sinus venosus atrial septal defect repair

Exploring Genetic Diversity of SOD2 and POU5F1 for Congenital Heart Disease in the Southwest Chinese Population.

Congenital heart disease (CHD) accounts for nearly one-third of all major congenital anomalies, with atrial septal defect (ASD) and ventricular septal defect (VSD) being the most common forms of simple CHD, which involve a large number of susceptibility genes. However, despite extensive research, the etiology of ASD and VSD remains unclear. Yunnan Province has advantages in exploring CHD pathogenesis due to its unique genetic background. Therefore, we aimed to evaluate the association between single nucleotide polymorphisms (SNPs) of genes and susceptibility to simple CHD in a specific population by means of a case-control study. A total of 337 healthy controls and 767 patients with simple CHD (501 ASD and 266 VSD) from China were recruited. Candidate SNPs were identified through whole-genome sequencing of pooled CHD patients and controls (pool-seq). Genotyping from 1,104 samples was performed, and stratified analysis was conducted to explore the association between positive SNPs and CHD subtypes. χ2 tests and logistic regression were used to analyze the relationship between each SNP and simple CHD. Of 11 SNPs identified, SOD2 rs62437333 (P = 0.005) and POU5F1 rs3130504 (P = 0.017) showed differences between the control and ASD cohorts. In the dominant inheritance model hypothesis, rs62437333 allele C carriers had increased ASD (odds ratio (OR) = 2.04, P = 0.005) and combined simple CHD risk (OR = 2.33, P = 0.012) compared to DD genotype, while rs3130504 allele C carriers had increased ASD risk (OR = 1.121, P = 0.045) compared to DD genotype.

Minimally invasive cardiac surgeries in 2021: annual report by Japanese society of minimally invasive cardiac surgery.

Although minimally invasive cardiac surgery (MICS) procedures are widely performed throughout Japan, nationwide data regarding treated cases are limited. Up-to-date results for cardiovascular surgery are vital for quality control in clinical practice. Presented here is the 2021 annual report based on data from the Japan Cardiovascular Surgery Database (JCVSD). Records noted in the JCVSD of patients who underwent mitral valve surgery, aortic valve replacement (AVR), coronary artery bypass grafting (CABG), atrial septum defect (ASD) closure, or cardiac tumor resection via right or left minithoracotomy, as well as thoracoscopic- or port-assisted, or robotic-assisted approaches, in 2021 were examined. Perioperative parameters including mortality and morbidity was evaluated. The 30-day and in-hospital mortalities for isolated mitral valve repair (n = 1211) were 0.1% and 0.2%, respectively, while those for all mitral valve repair (n = 2017) were 0.05% and 0.2%, respectively. More than 100 facilities were found to perform fewer than five MICS mitral valve surgery cases per year. As for MICS-AVR, 30-day and in-hospital mortalities for isolated AVR (n = 818) were 0.5% and 0.5%, respectively, while those for all AVR (n = 987) were 0.6% and 1.1%, respectively. Additionally, those for MICS-CABG (n = 400) were 0.8% and 0.5%, respectively. Those for ASD (n = 183) and cardiac tumor (n = 96), were 0.5% and 0.5%, respectively, and 0% and 1.0%, respectively. This is the first report of MICS results of procedures performed in Japan based on the 2021 JCVSD data. Additional results obtained with a similar data collection method are expected and details on MICS are being collected starting 2024.

Intracardiac ultrasound-guided transseptal puncture in horses: Outcome, follow-up, and perioperative anticoagulant treatment.

Cardiac catheterizations in horses are mainly performed in the right heart, as access to the left heart traditionally requires an arterial approach. Transseptal puncture (TSP) has been adapted for horses but data on follow-up and closure of the iatrogenic atrial septal defect (iASD) are lacking. To perform TSP and assess postoperative complications and iASD closure over a minimum of 4 weeks. Eleven healthy adult horses. Transseptal puncture was performed under general anesthesia. Serum cardiac troponin I concentrations were measured before and after puncture. Weekly, iASD closure was monitored using transthoracic and intracardiac echocardiography. Relationship between activated clotting time and anti-factor Xa activity during postoperative enoxaparin treatment was assessed in vitro and in vivo. Transseptal puncture was successfully achieved in all horses within a median duration of 22 (range, 10-104) minutes. Balloon dilatation of the puncture site for sheath advancement was needed in 4 horses. Atrial arrhythmias occurred in 9/11 horses, including atrial premature depolarizations (N = 1), atrial tachycardia (N = 5), and fibrillation (N = 3). Serum cardiac troponin I concentrations increased after TSP, but remained under the reference value in 10/11 horses. Median time to iASD closure was 14 (1-35) days. Activated clotting time correlated with anti-factor Xa activity in vitro but not in vivo. Transseptal puncture was successfully performed in all horses. The technique was safe and spontaneous iASD closure occurred in all horses. Clinical application of TSP will allow characterization and treatment of left-sided arrhythmias in horses.

Early Outcomes of Surgical Repair of Atrial Septal Defect with Right Anterolateral Minithoracotomy versus Traditional Median Sternotomy

Early Outcomes of Surgical Repair of Atrial Septal Defect with Right Anterolateral Minithoracotomy versus Traditional Median Sternotomy

Perioperative Anesthetic Management in Repair Diaphragmatic Hernia with Atrial Septal Defect and Pulmonary Hypertension

Introduction: Patients who had suffered disease of atrial septal defect (ASD) coming by pulmonary hypertension (PH) often present a clinical dilemma. Both of these disorders are congenital anomalies that often appear in pediatrics. Anaesthetic management in diaphragmatic hernia repair with this comorbidity requires precision and accuracy to avoid morbidity and mortality during surgery. The right management and care of anesthetic procedures is needed for patients who will be operated on with these two disorders. Objective: To describe the anesthetic management of a diaphragmatic hernia repair patient with comorbid ASD and pulmonary hypertension. Case report: The patient, a 1.5-month-old female baby born, has presented with shortness of breath complaints since the birth. Those were born spontaneously at the midwife's office and did not cry immediately, and a history of blueing and decreased consciousness was admitted for 20 days. Based on the examination, the diagnosis of diaphragmatic hernia from echocardiography found ASD and PH with a left ventricular ejection fraction of 64%. The patient was planned for diaphragmatic hernia repair under general anesthesia. Induction of anesthesia was performed with 5 mcg of fentanyl and inhalation anesthetic 3.5 vol% sevoflurane. After the endotracheal tube (ETT) was attached, the patient was desaturated to 50%, then the hyperventilated oxygenation was performed and positioned with knee chest position, and then milrinone at a dose of 1 mcg/min was given, saturation rose to 100%. During intraoperative ventilation control with manual bagging and maintenance anesthesia with inhalation ansethetic sevoflurane of 3.2 vol%. After surgery, the patient was admitted and observed in the pediatric intensive care unit for 2 days before extubation. Conclusion: Appropriate perioperative management in ASD patients with PH can reduce perioperative morbidity and mortality.

Mid-term outcomes of minimally invasive surgery for partial atrioventricular septal defect in children

Objective: This study aims to describe the mid-term outcomes of minimally invasive surgery for partial atrioventricular septal defect in children. Summary: Partial atrioventricular septal defect is one of the three types of atrioventricular septal defect, accounting for about 3.5% of congenital heart disease. Traditionally, complete repair has been performed via sternotomy. However, with the advancement of minimally invasive surgical techniques in treating congenital heart conditions, we conducted this study to assess the feasibility and mid-term outcomes of this approach. Subjects and methods: This descriptive study spanned from January 2018 to December 2023, involving 30 patients diagnosed with partial atrioventricular septal defect who underwent minimally invasive complete repair. The cohort comprised 12 males and 18 females, with an average age of 18 months and average weight of 10.3 kg. The mean diameter of the primary atrial septal defect was 15 mm. Eight patients (26.7%) exhibited moderate to severe mitral regurgitation, and the average pulmonary artery pressure was 37 mmHg. Results: The average durations of cardiopulmonary bypass and aortic cross-clamp were 82 minutes and 58 minutes, respectively. None of the patients required sternotomy. The average time of artificial ventilator post-surgery was 6.9 hours, with a mean hospital stay of 7.6 days. Postoperative echocardiography showed promising results: complete closure of atrial septal defect, with 90% of patients having absent or mild mitral valve regurgitation, only 10% experienced moderate mitral valve regurgitation. The average follow-up period was 38 months, during which there were no postoperative fatalities. One patient required reoperation due to severe mitral regurgitation from an anterior cleft. Conclusion: Minimally invasive surgery for partial atrioventricular septal defect in children can be safely performed, yielding favorable mid-term outcomes during follow-up.

Early outcomes of minimal invasive surgery via the axillary approach for complex congenital heart disease at the Cardiovascular Center - E hospital

Objective: This study aims to outline the initial outcomes of implementing minimally invasive surgery via the right axillary approach to completely repair complex congenital heart diseases. Summary: Minimally invasive surgical techniques have gained widespread adoption in managing simple congenital heart diseases such as atrial septal defect, ventricular septal defect, partial atrioventricular septal defect, cor triatriatum, and partial anomalous pulmonary venous return. Postoperative results have demonstrated equivalence, if not superiority, to traditional sternotomy procedures while offering enhanced cosmetic benefits. However, for more intricate congenital heart conditions such as tetralogy of Fallot (TOF), complete atrioventricular septal defect (CAVSD), and Ebstein syndrome, this study evaluates the early outcomes of employing minimally invasive surgery via the right axillary approach, a technique that remains relatively uncommon globally. Our study seeks to assess the initial outcomes of this approach in managing complex congenital heart diseases. Subjects and methods: descriptive method based on a series of cases. From April 2023 to December 2023, 45 patients diagnosed with complex congenital heart disease underwent minimally invasive surgery utilizing the axillary approach. This cohort comprised 40 patients with tetralogy of Fallot, 3 patients with complete atrioventricular septal defect, and 2 patients with Ebstein syndrome. Results: All procedures were technically successful, without requiring sternotomy. The cardiopulmonary bypass times for the TOF, complete AVSD, and Ebstein syndrome groups were 81 minutes, 91 minutes, 96 minutes, respectively. Corresponding aortic cross - clamp times were 70 minutes, 72 minutes, and 74 minutes. There were no postoperative fatalities or significant complications. Postoperative echocardiographic evaluations demonstrated favorable outcomes. Conclusion: Minimally invasive surgery via the axillary approach for managing complex congenital heart diseases yields promising early results and offers notable cosmetic advantages.

Occlusion of Iatrogenic Atrial Septal Defects After Mitral Valve-in-Valve Implantation With a Novel Bioresorbable Occlusion Device

Occlusion of Iatrogenic Atrial Septal Defects After Mitral Valve-in-Valve Implantation With a Novel Bioresorbable Occlusion Device

Surgical treatment of a newborn with critical aortic coarctation using palliative stenting: a case report

Introduction. Coarctation of the aorta (CoA) is a congenital severe narrowing of the aortic isthmus, which in turn is often accompanied by impaired organ perfusion or even cardiogenic shock. In newborns with critical CoA in the case of patent ductus arteriosus (PDA) closure, the clinical condition of patients with this congenital heart defect (CHD) sharply worsens and leads to multiple organ failure. In this group of children, mortality ranges from 30 to 50% of infant mortality from CHD. This case demonstrates the positive effect of palliative stenting of a narrowed section of the aorta, which made it possible to safely perform radical surgery for CHD.Case description. Nine-year-old male patient with body weight of 3,5 kg and body length of 53 cm was admitted to the clinic with a diagnosis of CHD: Critical CoA. Secundum atrial septal defect. PDA. Multiple organ failure. Taking into account the severe comorbidity status in the form of multiple organ failure, the high risk of necrotizing enterocolitis, case conference decided to perform a step-by-step CHD treatment as follows: palliative endovascular stenting of critical CoA, followed by radical surgery after stabilization of the patient's condition. The plan was successfully implemented.Conclusion. Сritical CoA stenting can be used as a bridge to radical surgery of the defect in newborns with multiple organ failure. This palliative intervention helps to stabilize the child for up to 3 weeks and more safely perform radical surgery of CoA.

Incidental discovery of unilateral hydronephrosis unveiling psoas major desmoid-type fibromatosis in a 24-year-old male: A case report with a 5-year follow-up.

Desmoid-type fibromatosis (DTF), also known as aggressive fibromatosis, is a rare neoplasm originating from the fascial or musculoaponeurotic tissues. While benign and characterized by slow growth, it exhibits local aggressiveness and lacks specific clinical characteristics. However, in a considerable percentage of patients, it could be asymptomatic and discovered by accident during routine clinical examinations. Only a few cases of DTF arising from the psoas major muscle have been reported in the medical literature. A 24-year-old male, asymptomatic and without significant personal or family medical history, was diagnosed with grade 2 hydronephrosis by abdominal ultrasonography during a routine physical examination. This diagnosis was made 15 days after undergoing uncomplicated open-heart surgery to repair an atrial septal defect. Intravenous pyelogram revealed hydronephrosis with dilation of the pelvicalyceal system. Ureteroscopy ruled out any intrinsic lesions of the ureter. Contrast-enhanced computed tomography identified a 3.5 × 2 × 5.2 cm mass in the retroperitoneum, closely associated with the psoas muscle and enveloping the ureter adjacent to the iliac artery. Postoperative pathological analysis confirmed a definitive diagnosis of sporadic DTF. The patient underwent exploratory abdominal surgery, during which the tumor was resected without any intraoperative complications. After close monitoring over a 5-year follow-up period, which included periodic physical examinations, magnetic resonance imaging, and ultrasonography, no local recurrence was detected. Achieving an accurate preoperative diagnosis presents a challenge in cases involving retroperitoneal tumors originating from the psoas major muscle and encasing the ureter. However, the insertion of a double J stent is deemed a crucial step in the surgical process, facilitating the dissection and isolation of the ureter from the tumor while preserving kidney function.

Atrial Septal Defect Stent Compression During Resuscitation of an Infant With Hypoplastic Left Heart Syndrome.

A newborn with hypoplastic left heart syndrome underwent a Norwood procedure with a Sano shunt. A month later, he had an atrial septal defect (ASD) stent placed due to ASD size and flow restriction. Three weeks later, he had sudden bradycardia and cardiac arrest in the intensive care unit. He was resuscitated and cannulated for extracorporeal membrane oxygenation (ECMO) through a right neck approach. An attempt to wean him from ECMO a week later failed due to hypoxia. Echocardiography showed ASD flow restriction and a chest x-ray showed flattening of the left atrial side of the ASD stent from chest compression resulting in a restrictive ASD. The patient underwent surgical removal of the ASD stent with ASD enlargement and was successfully weaned from ECMO after surgery.

Evaluation of intracardial hemodynamics in children under 1 year of age with atrial septal defect

Aim: evaluation of the intracardiac hemodynamics and determination indications for early correction of the atrial septal defect in children before 1 year age.Methods. The study included patients observed from 2010 to 2021. The first group was formed from children under the age of 12 months with ASD and were observed for the next 4 years until its interventional or surgical elimination. The second group included healthy children of the appropriate age. All patients underwent an echocardiographic (ECHO) study with assessment of the main parameters of hemodynamics and intracardial structures.Results. The first group included 887 children with ASD, the control group included 887 healthy children. The age of the patients included in the study was 6 ± 2.6 months. for group I and 6 ± 2.5 months. for the second one. It was found that in young children with ASD, the first manifestation of hemodynamic changes was dilatation of the right ventricle, then the right atrium and finally dilatation of the pulmonary trunk, which was accompanied by an increase in pressure in the pulmonary circulation and weight loss. In 11% of patients, spontaneous closure of the ASD occurs within the first year of life. Almost 20% of patients are younger than 6 months. have clinical and hemodynamic indications for surgical treatment of ASD.Conclusions. Indications for the atrial septal defect closure should be determined taking into account clinical, anatomical and hemodynamic parameters.

Ebstein Anomaly: Insights on Isolated Atrial Septal Defect Device Closure.

Ebstein Anomaly: Insights on Isolated Atrial Septal Defect Device Closure.

Noonan Syndrome Growth Charts and Genotypes: 15-year Longitudinal Single-centre Study.

Growth patterns in Noonan syndrome (NS) remain relatively unknown. The objective of this study was to provide growth reference curves for patients with NS and identify correlations between their growth, genotype, and clinical features. This was a 15-year-long, monocentric, observational, retrospective, non-interventional study. Children with NS followed up between 2005 and 2022 at 'Bambino Gesù' Children's Hospital, Italy, were included, and excluded if they had received growth hormone treatment. Comparison of growth curves of participants with NS versus the general Italian population and further genotypic analyses were performed. Overall, 190 eligible participants with NS were identified, with median (interquartile range) age of 14.01 (9.05-19.25) years, (55.8% male). Cardiovascular anomalies were present in 85.3% of participants, most commonly pulmonary stenosis (52.6%) and atrial septal defects (36.8%); 48.1% of male participants had cryptorchidism. The most frequently detected mutations were in PTPN11 (66.3%) and SOS1 (13.9%). NS-sex-specific centile curves for height, weight, body mass index, and height velocity were produced. For both sexes, the 50th percentile of height and weight for participants with NS overlapped with the 3rd percentile for the general Italian population. Both sexes with a PTPN11 mutation had a significantly lower height and weight than those with 'other mutations' at 5 years old. No significant associations were observed between cardiac anomalies and PTPN11 mutation status. We present longitudinal data describing growth curves and trends, the natural history, and genotypes of the NS population, which provide a useful tool for clinicians in the management of NS.

Chronic invasive fungal rhinosinusitis with septal perforation: a case report

Background: Chronic Invasive Fungal Rhinosinusitis (CIFRS) is a sub-entity of fungal rhinosinusitis, with the most common causes being Aspergillus and Mucor. Non-specific symptoms such as nasal obstruction, headaches, face pain, rhinorrhea, and epistaxis are frequently observed in patients with CIFRS. Extension to the nasal septal is a scarce case. This case report aims to present a rare case report of a 50-year-old female considered immunocompetent with chronic invasive fungal rhinosinusitis with septal perforation at our hospital who underwent Functional Endoscopic Sinus Surgery (FESS). Case Presentation: Fifty-year-old female was referred to the Otorhinolaryngology Department, Mangusada Regional Hospital, with a blocked nose, especially on the right side, with frequently purulent nasal discharge, headache, and she had a foul smell in the nose for about 5 years, then in the last few months, the symptoms became worse, and she frequently had bloody discharge and anosmia. The patient came to our hospital due to failure of previous medical therapy. She denied any history of underlying systemic disease, relevant trauma, and nasal surgery. A large polypoid mass with an obstructed right middle meatus was detected on nasal endoscopy. A dark-brown substance resembling clay was found in the right posterior nasal cavity, close to the posterior nasal septum. The same material was seen in the left posterior nasal cavity, close to the posterior nasal septum. Computed Tomography (CT)-scan demonstrated a soft tissue density in the right maxillary sinus. The density extended into the left nasal cavity through a septal defect. The patient was done surgically with FESS to restore the drainage of the nasal cavity and paranasal sinuses. It is crucial to remove all the debris and infected tissue altogether. After the surgery, the patient was given nasal irrigation therapy with physiological saline solution 2 times a day and the condition improved. Conclusion: Diagnosing invasive fungal rhinosinusitis can be challenging due to its non-specific clinical presentation. Awareness, early diagnosis, and intervention help prevent permanent complications.