Jakob L Fischer, Nikitha Kosaraju, Katherine M Lucarelli, Connie M Sears, Jivianne T Lee, Daniel M Beswick, Daniel B Rootman, Marilene B Wang, Jeffrey D Suh
{"title":"口腔干预和疾病对急性侵袭性真菌性鼻窦炎严重程度和预后的影响。","authors":"Jakob L Fischer, Nikitha Kosaraju, Katherine M Lucarelli, Connie M Sears, Jivianne T Lee, Daniel M Beswick, Daniel B Rootman, Marilene B Wang, Jeffrey D Suh","doi":"10.1177/19458924251382514","DOIUrl":null,"url":null,"abstract":"<p><p>BackgroundAcute invasive fungal rhinosinusitis (AIFRS) is an aggressive and often fatal disease process that principally impacts immunocompromised patients. Maxillary dental trauma and infections have been associated with the development of maxillary sinus fungal balls, but the role of dental procedures/trauma in the pathogenesis of AIFRS remains poorly defined.ObjectiveThis study seeks to review a single-institutional experience with AIFRS and examine the association between dental events and AIFRS severity and outcomes.MethodsRetrospective review of 95 consecutive patients with biopsy-proven AIFRS treated at a tertiary institution between 2010 and 2024. Demographic information, comorbidities, disease course and outcomes were evaluated. The primary objective was to evaluate the impact of antecedent dental events on AIFRS morbidity and mortality. Secondary objectives included evaluating variability in demographic factors, comorbidities, and extent of disease.ResultsEleven patients with an antecedent dental event within 2 weeks of AIFRS diagnosis were identified for a rate of 11.6%. Dental AIFRS patients were more likely to be African American (<i>P</i> = .003) and more likely to have diabetes mellitus as their underlying immunodeficiency (<i>P</i> = .03) than non-dental AIFRS patients. Patients with dental-related AIFRS were more likely to present with invasion of the orbit (OR 6.0, 95% CI 1.2-29.5) and nasal floor (OR 4.2, 95% CI 1.1-17.1) than non-dental AIFRS patients. There was no difference in mortality between dental and non-dental AIFRS (36.4% vs 52.4%, <i>P</i> = .31).ConclusionMore investigation is necessary to further evaluate the association between dental events and the development of AIFRS. In our cohort, 11.6% of patients experienced AIFRS within 2 weeks of a dental event and these patients tended to present with higher rates of orbital involvement without a resultant increase in mortality.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924251382514"},"PeriodicalIF":2.3000,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Influence of Dental Intervention and Disease on Acute Invasive Fungal Rhinosinusitis Severity and Outcomes.\",\"authors\":\"Jakob L Fischer, Nikitha Kosaraju, Katherine M Lucarelli, Connie M Sears, Jivianne T Lee, Daniel M Beswick, Daniel B Rootman, Marilene B Wang, Jeffrey D Suh\",\"doi\":\"10.1177/19458924251382514\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>BackgroundAcute invasive fungal rhinosinusitis (AIFRS) is an aggressive and often fatal disease process that principally impacts immunocompromised patients. Maxillary dental trauma and infections have been associated with the development of maxillary sinus fungal balls, but the role of dental procedures/trauma in the pathogenesis of AIFRS remains poorly defined.ObjectiveThis study seeks to review a single-institutional experience with AIFRS and examine the association between dental events and AIFRS severity and outcomes.MethodsRetrospective review of 95 consecutive patients with biopsy-proven AIFRS treated at a tertiary institution between 2010 and 2024. Demographic information, comorbidities, disease course and outcomes were evaluated. The primary objective was to evaluate the impact of antecedent dental events on AIFRS morbidity and mortality. Secondary objectives included evaluating variability in demographic factors, comorbidities, and extent of disease.ResultsEleven patients with an antecedent dental event within 2 weeks of AIFRS diagnosis were identified for a rate of 11.6%. Dental AIFRS patients were more likely to be African American (<i>P</i> = .003) and more likely to have diabetes mellitus as their underlying immunodeficiency (<i>P</i> = .03) than non-dental AIFRS patients. Patients with dental-related AIFRS were more likely to present with invasion of the orbit (OR 6.0, 95% CI 1.2-29.5) and nasal floor (OR 4.2, 95% CI 1.1-17.1) than non-dental AIFRS patients. There was no difference in mortality between dental and non-dental AIFRS (36.4% vs 52.4%, <i>P</i> = .31).ConclusionMore investigation is necessary to further evaluate the association between dental events and the development of AIFRS. In our cohort, 11.6% of patients experienced AIFRS within 2 weeks of a dental event and these patients tended to present with higher rates of orbital involvement without a resultant increase in mortality.</p>\",\"PeriodicalId\":7650,\"journal\":{\"name\":\"American Journal of Rhinology & Allergy\",\"volume\":\" \",\"pages\":\"19458924251382514\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-09-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Rhinology & Allergy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/19458924251382514\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OTORHINOLARYNGOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Rhinology & Allergy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/19458924251382514","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
急性侵袭性真菌性鼻窦炎(AIFRS)是一种侵袭性且通常致命的疾病过程,主要影响免疫功能低下的患者。上颌牙外伤和感染与上颌窦真菌球的发展有关,但牙科手术/外伤在AIFRS发病机制中的作用仍不明确。目的本研究旨在回顾单一机构的AIFRS经验,并检查牙科事件与AIFRS严重程度和结局之间的关系。方法回顾性分析2010年至2024年在某高等院校连续治疗的95例经活检证实的AIFRS患者。评估人口统计信息、合并症、病程和结局。主要目的是评估先前的牙科事件对AIFRS发病率和死亡率的影响。次要目的包括评估人口统计学因素、合并症和疾病程度的可变性。结果在AIFRS诊断后2周内有牙齿事件的患者有6例,检出率为11.6%。与非牙科AIFRS患者相比,牙科AIFRS患者更有可能是非裔美国人(P = 0.003),更有可能将糖尿病作为其潜在免疫缺陷(P = 0.03)。与非牙齿相关的AIFRS患者相比,与牙齿相关的AIFRS患者更容易出现眼眶侵犯(OR 6.0, 95% CI 1.2-29.5)和鼻底侵犯(OR 4.2, 95% CI 1.1-17.1)。牙科和非牙科AIFRS的死亡率无差异(36.4% vs 52.4%, P = 0.31)。结论口腔事件与AIFRS发生的关系有待进一步研究。在我们的队列中,11.6%的患者在牙齿事件发生后2周内出现AIFRS,这些患者倾向于表现出更高的眼眶受累率,但没有因此增加死亡率。
Influence of Dental Intervention and Disease on Acute Invasive Fungal Rhinosinusitis Severity and Outcomes.
BackgroundAcute invasive fungal rhinosinusitis (AIFRS) is an aggressive and often fatal disease process that principally impacts immunocompromised patients. Maxillary dental trauma and infections have been associated with the development of maxillary sinus fungal balls, but the role of dental procedures/trauma in the pathogenesis of AIFRS remains poorly defined.ObjectiveThis study seeks to review a single-institutional experience with AIFRS and examine the association between dental events and AIFRS severity and outcomes.MethodsRetrospective review of 95 consecutive patients with biopsy-proven AIFRS treated at a tertiary institution between 2010 and 2024. Demographic information, comorbidities, disease course and outcomes were evaluated. The primary objective was to evaluate the impact of antecedent dental events on AIFRS morbidity and mortality. Secondary objectives included evaluating variability in demographic factors, comorbidities, and extent of disease.ResultsEleven patients with an antecedent dental event within 2 weeks of AIFRS diagnosis were identified for a rate of 11.6%. Dental AIFRS patients were more likely to be African American (P = .003) and more likely to have diabetes mellitus as their underlying immunodeficiency (P = .03) than non-dental AIFRS patients. Patients with dental-related AIFRS were more likely to present with invasion of the orbit (OR 6.0, 95% CI 1.2-29.5) and nasal floor (OR 4.2, 95% CI 1.1-17.1) than non-dental AIFRS patients. There was no difference in mortality between dental and non-dental AIFRS (36.4% vs 52.4%, P = .31).ConclusionMore investigation is necessary to further evaluate the association between dental events and the development of AIFRS. In our cohort, 11.6% of patients experienced AIFRS within 2 weeks of a dental event and these patients tended to present with higher rates of orbital involvement without a resultant increase in mortality.
期刊介绍:
The American Journal of Rhinology & Allergy is a peer-reviewed, scientific publication committed to expanding knowledge and publishing the best clinical and basic research within the fields of Rhinology & Allergy. Its focus is to publish information which contributes to improved quality of care for patients with nasal and sinus disorders. Its primary readership consists of otolaryngologists, allergists, and plastic surgeons. Published material includes peer-reviewed original research, clinical trials, and review articles.