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접형동 국균증에 의한 실명 치험 1예

Other Titles
 Blindness Secondary to Sphenoid Fungus Ball 
Authors
 권오진  ;  전시영  ;  김경수  ;  김진평 
Citation
 Journal of Rhinology, Vol.15(2) : 148-151, 2008 
Journal Title
Journal of Rhinology
ISSN
 1229-1498 
Issue Date
2008
Keywords
Blindness ; Sphenoid sinus ; Fungus ball ; Sphenoethmoidectomy
Abstract
The close vicinity of the optic nerve to the sphenoid sinus may cause visual loss in the sphenoid fungus ball. We present a case of blindness secondary to sphenoid fungus ball without any evidence of orbital invasion in imaging studies. A 61-year-old man, suffering from uncomplicated diabetes, was referred for right visual loss that developed 1 day ago. He perceived hand motion on the right. CT and MRI revealed a fungus ball in the right sphenoid sinus. However, there was no evidence of orbital invasion. Endoscopic sphenoethmoidectomy was performed to remove the fungus ball. Systemic mega-dose steroid and amphotericin B were started because he lost the light perception 3 days after surgery. Biopsy revealed aspergillus fungus ball and no evidence of mucosal invasion. However, blindness was not reversed. Evidence of orbital invasion in imaging diagnosis is elusive in sphenoid fungus ball; therefore, systemic antifungal treatment should be initiated and early endoscopic sphenoidotomy should be performed in case of rapidly progressing visual loss, especially in diabetic or immunocompromised patients. Mega-dose steroid therapy for optic neuropathy should be selective because it may aggravate underlying systemic diseases to cause early termination of systemic antifungal treatment.
Files in This Item:
T200895714.pdf Download
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Su(김경수) ORCID logo https://orcid.org/0000-0003-1460-0640
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/108642
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