{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:29:47Z","timestamp":1790555387436,"version":"4.1.0"},"reference-count":46,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,5,22]],"date-time":"2021-05-22T00:00:00Z","timestamp":1621641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Occurrence of invasive fungal respiratory superinfections in patients with COVID\u201019 has gained increasing attention in the latest studies. Yet, description of acute invasive fungal sinusitis with its management in those patients is still scarce. This study aims to describe this recently increasing clinical entity in relation to COVID\u201019 patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Longitudinal prospective study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Prospective longitudinal study included patients diagnosed with acute invasive fungal rhinosinusitis after a recent COVID\u201019 infection. Antifungal agents given included amphotericin B, voriconazole, and\/or posaconazole. Surgical treatment was restricted to patients with PCR negative results for COVID\u201019. Endoscopic, open, and combined approaches were utilized to eradicate infection. Follow\u2010up for survived patients was maintained regularly for the first postoperative month.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 36 patients with a mean age of 52.92\u2009\u00b1\u200911.30\u2009years old were included. Most common associated disease was diabetes mellitus (27.8%). Mycological analysis revealed infection with Mucor and Aspergillus species in 77.8% and 30.6% of patients, respectively. Sino\u2010nasal, orbital, cerebral, and palatine involvement was found in 100%, 80.6%, 27.8%, and 33.3% of patients, respectively. The most common reported symptoms and signs are facial pain (75%), facial numbness (66.7%), ophthalmoplegia, and visual loss (63.9%). All patients were treated simultaneously by surgical debridement with antifungal medications except for two patients with PCR\u2010positive swab for COVID\u201019. These two patients received antifungal therapy alone. Overall survival rate was 63.89% (23\/36).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Clinical suspicion of acute invasive fungal sinusitis among COVID\u201019 patients and early management with antifungal therapy and surgical debridement is essential for better outcomes and higher survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      4\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 131:2652\u20132658, 2021\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.29632","type":"journal-article","created":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T11:54:06Z","timestamp":1621425246000},"page":"2652-2658","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":101,"title":["Invasive Fungal Sinusitis in Post\n                    <scp>COVID<\/scp>\n                    \u201019 Patients: A New Clinical Entity"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8623-868X","authenticated-orcid":false,"given":"Noha Ahmed","family":"El\u2010Kholy","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery, Faculty of Medicine Mansoura University  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7004-8697","authenticated-orcid":false,"given":"Ahmed Musaad Abd","family":"El\u2010Fattah","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery, Faculty of Medicine Mansoura University  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1564-0890","authenticated-orcid":false,"given":"Yasser W.","family":"Khafagy","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery, Faculty of Medicine Mansoura University  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41564-020-0695-z"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-020-2012-7"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2020.02.016"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202009-3400OC"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.3109\/13693780903177790"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2020.09.032"},{"key":"e_1_2_7_8_1","article-title":"Rhino\u2010orbital mucormycosis associated with COVID\u201019","volume":"12","author":"Mehta S","year":"2020","journal-title":"Cureus"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20520"},{"key":"e_1_2_7_10_1","unstructured":"MasoudH EG ZakyS BakiA et al.Management Protocol for COVID\u201019 Patients Version 1.4 Ministry of Health and Population (MOHP) Egypt. 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