■描述一系列9例表现为Pott\的浮肿性肿瘤(ROCM-PPT)的犀牛-流脑毛霉菌病(ROCM)患者的临床放射学特征和手术结果。
■分析了2020年3月至2021年12月期间9例ROCM-PPT患者的记录。临床特征,放射学,组织病理学,手术发现,注意到管理和结果。在ROCM和无PPT的患者和对照组之间比较了额窦气化和流出道构型。
■在研究期间发现的284例ROCM患者中有9例(3.2%)被诊断为ROCM-PPT。有6名(66.7%)男性,中位年龄为54(IQR46-60)岁。8例(88.9%)患者患有糖尿病,7例(77.8%)COVID-19阳性。骨髓炎的放射学特征,所有患者均可见骨膜下脓肿形成和硬脑膜强化。患者和对照组之间的气化或额窦流出道构型没有显着差异。所有患者均接受了额骨清创术和额窦外置术的颅骨切除术。所有患者均接受抗真菌药物治疗数月。所有患者在中位随访21(IQR18-23)个月时均有症状改善。重复的CT/MRI扫描显示,8名患者中有6名(75%)的随访影像显示疾病消退/消退,和其他两个稳定的疾病。
■ROCM-PPT是一种罕见的,在最近的COVID-19大流行期间出现了更多的毛霉菌病延迟并发症。积极的骨髓骨清创术和抗真菌治疗结果良好。
UNASSIGNED: To describe clinicoradiological features and surgical outcomes in a series of nine patients with rhino-orbito-cerebral mucormycosis (ROCM) who presented with Pott\'s puffy tumor (ROCM-PPT).
UNASSIGNED: The records of nine patients with ROCM-PPT seen between March 2020 and December 2021 were analysed. Clinical features, radiology, histopathology, operative findings, management and outcome were noted. Frontal sinus pneumatisation and outflow tract configuration was compared between patients and controls with ROCM and no PPT.
UNASSIGNED: ROCM-PPT was diagnosed in 9 of 284 (3.2 %) patients with ROCM seen during the study period. There were six (66.7 %) males and the median age was 54 (IQR 46-60) years. Eight (88.9 %) patients had diabetes mellitus and seven (77.8 %) had been COVID-19 positive. Radiological features of osteomyelitis, subperiosteal abscess formation and dural enhancement were seen in all patients. No significant differences in pneumatisation or frontal sinus outflow tract configuration were noted between patients and controls. All patients underwent a craniectomy with frontal bone debridement and frontal sinus exteriorisation. All patients were treated with anti-fungal agents for several months. All patients had symptomatic improvement at a median follow-up of 21 (IQR 18-23) months. Repeat CT/MRI scans showed disease regression/resolution in six out of eight (75 %) patients with follow-up imaging, and stable disease in two others.
UNASSIGNED: ROCM-PPT is a rare, delayed complication of mucormycosis that was seen in larger numbers during the recent COVID-19 pandemic. Aggressive debridement of osteomyelitic bone and antifungal therapy results in a good outcome.