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J Neurol Surg B Skull Base 2017; 78(01): 089-095
DOI: 10.1055/s-0036-1585089
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Invasive Aspergillosis of Anterior Skull Base in the Immunocompetent Host: Outcomes with a Combined Treatment Modality–An Institutional Experience

Saurin R. Shah
1   Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
,
Amit Keshri
1   Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
,
Simple Patadia
1   Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
,
Rungmei S.K. Marak
2   Department of Microbiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
,
Sanjay Behari
1   Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
› Author Affiliations
Further Information

Publication History

25 April 2016

27 May 2016

Publication Date:
18 July 2016 (online)

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Abstract

Objectives To study outcomes with voriconazole therapy in immunocompetent individuals following maximal safe endoscopic resection in invasive aspergillosis of the anterior skull base.

Design Retrospective study of patients with chronic invasive aspergillosis including symptomatology, extent of disease, and response to voriconazole following maximal safe resection in immunocompetent individuals.

Setting Tertiary care superspeciality referral center.

Participants Ten consecutive patients of invasive aspergillosis of anterior skull base managed over a period of 2 years.

Main Outcome Measures Symptom resolution with systemic voriconazole and radiologic evaluation following systemic antifungals as per predefined protocol.

Conclusions Maximal safe resection via transnasal endoscopic route followed by systemic antifungals provides excellent outcomes in invasive skull base aspergillosis.

Although liver and renal functions, besides visual acuity, need serial monitoring, voriconazole is well tolerated by our patients.

Keywords

invasive aspergillosis - skull base - immunocompetent - endoscopic resection - voriconazole - itraconazole
 

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