321829

PERINEURAL SPREAD IN INVASIVE FUNGAL SINUSITIS: UNDERRECOGNIZED COMPLICATION OF HEAD AND NECK INVASIVE FUNGAL INFECTION

Article

Last updated: 04 Jan 2025

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RADIODIAGNOSIS

Abstract

Background: Peri-neural spread of fungal infection is a potentially fatal condition. Identification of the major risk factors, as well as rigorous analysis of clinical features and radiological findings, may improve the chances of prompt diagnosis and better patient outcome. Aim of the work: In this study we pursue to investigate perineural spread in patients with invasive fungal infection. Patients and Methods: An institutional Review Board (IRB) approved retrospective study was conducted between April 2021 and October 2022 on 17 patients (10 male and 7 female) presented with clinical concern of fungal sinusitis and suspected perineural spread. The patients have performed contrast enhanced MRI and CT examination to evaluate sites of peri-neural extension, the involved cranial nerves, and the anatomical location. Histopathological data were obtained through surgically excised specimens in all cases. Results: In our study, the peri-neural spread was found with involvement of pterygopalatine fossa (PPF) (16 cases) (94.1%), foramen rotundum (FR) (13 cases) (76.5%), vidian canal (VC) (two cases) (11.8%), Meckel's cave (MC) (10 cases) (58.8%), cavernous sinus (CS) (8 cases) (47%), main trigeminal nerve till pons (two cases) (11.8%), 16 out of 17 cases (94.1%) showed involvement of maxillary division of trigeminal nerve (V2) and to lesser extent ophthalmic division (V1) (only 1 case) and mandibular division (V3) (6 cases) at infra-temporal fossa. Conclusion: Peri-neural spread can occur in invasive fungal infections, and most commonly along the anatomical distribution of trigeminal nerve and its branches “especially V2".

DOI

10.21608/asmj.2023.321829

Keywords

perineural spread, fungal sinusitis, pterygopalatine fossa, Trigeminal nerve

Authors

First Name

Sameh

Last Name

Abokoura

MiddleName

-

Affiliation

Department of Radiology, National Liver Institute, Menoufia University, Shebin Elkoum, Egypt.

Email

samehabokoura@gmail.com

City

-

Orcid

-

First Name

Ayda

Last Name

Youssef

MiddleName

-

Affiliation

Department of Radiology, National Cancer Institute, Cairo University, Cairo, Egypt.

Email

aydayoussefegypt@gmail.com

City

-

Orcid

-

First Name

Ola

Last Name

Shetat

MiddleName

Magdy Mohamed

Affiliation

Department of Radiology, National Cancer Institute, Cairo University, Cairo, Egypt.

Email

-

City

-

Orcid

-

First Name

Ayman

Last Name

Aboalregal

MiddleName

-

Affiliation

Department of Radiology, National Cancer Institute, Cairo University, Cairo, Egypt.

Email

aymanaboalregal@hotmail.com

City

-

Orcid

-

Volume

74

Article Issue

3

Related Issue

43980

Issue Date

2023-09-01

Receive Date

2023-10-17

Publish Date

2023-09-01

Page Start

679

Page End

689

Print ISSN

0002-2144

Online ISSN

2735-3540

Link

https://asmj.journals.ekb.eg/article_321829.html

Detail API

https://asmj.journals.ekb.eg/service?article_code=321829

Order

321,829

Type

Original Article

Type Code

1,311

Publication Type

Journal

Publication Title

Ain Shams Medical Journal

Publication Link

https://asmj.journals.ekb.eg/

MainTitle

PERINEURAL SPREAD IN INVASIVE FUNGAL SINUSITIS: UNDERRECOGNIZED COMPLICATION OF HEAD AND NECK INVASIVE FUNGAL INFECTION

Details

Type

Article

Created At

26 Dec 2024