Abstract
The case of a 73-year-old man with acute invasive fungal sinusitis involving the left orbital apex is described. The diagnosis of fungal disease was based on clinical presentation including severe visual loss, computed tomography and magnetic resonance imaging of the paranasal sinuses and histopathological findings. Intravenous anti-fungal therapy （Voriconazole） and extended resection surgery including orbital exenteration were implemented. During 2 years and 5 months follow-up, the patient did not show recurrence of sinusitis. Invasive fungal sinusitis can rapidly spread beyond the sinus cavity into the intracranial space and orbit causing a life-threatening condition. Recently, more cases treated without orbital exenteration have been reported owing to the recent progress in endoscopic sinus surgeries （ESS）, in addition to the development of antifungal drugs with fewer side effects, which made the long-term use of antifungal drugs possible. However, there are cases where systemic administration of antifungal drugs and ESS alone cannot control the progression of the disease. We report our experience of this case of invasive fungal sinusitis treated with orbital exenteration and discuss the indications for extended resection surgery.
