{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T01:17:20Z","timestamp":1789521440467,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T00:00:00Z","timestamp":1658707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006459","name":"Children's Hospital Los Angeles","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006459","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Pediatric invasive fungal rhinosinusitis (IFS) is a devastating infection that manifests almost exclusively in immunocompromised children. The goal of this work was to determine which clinical features carry prognostic value for survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of children with a histopathological diagnosis of IFS was performed at an academic tertiary care institution from 1990 to 2021. Clinical variables were collected to generate survival and life\u2010table estimators at 6\u2010months and 1\u2010year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighteen patients were included in this analysis, with a mean age of 9.8\u2009years (range, 1\u201317\u2009years). Most children were neutropenic (<jats:italic>n<\/jats:italic>\u00a0=\u00a015, 83.3%), with acute lymphoblastic leukemia (<jats:italic>n<\/jats:italic>\u00a0=\u00a010, 55.6%) representing the most common primary diagnosis. A mean of 3.2 operations (range 1\u20137 operations) was performed per patient for either mucormycosis (<jats:italic>n<\/jats:italic>\u00a0=\u00a010, 55.6%) or aspergillosis (<jats:italic>n<\/jats:italic>\u00a0=\u00a08, 44.4%). The mean time to absolute neutrophil count recovery was 65.8\u2009days (range 20\u2013137\u2009days), with a 6\u2010month and 1\u2010year survival rate of 47.6% and 41.7%, respectively. Gross total resection (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.006, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), number of antifungals (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.0004, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.0003), and total operation number (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.0032, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.0035), served as positive prognostic factors for 6\u2010month and 1\u2010year survival. Conversely, altered mental status (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.0026), cerebral involvement (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.0010), cranial neuropathies (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), hyperglycemia (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.0445, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.0208), and intensive care unit status (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.0013) served as negative prognostic factors for 6\u2010month and 1\u2010year survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Several key elements were identified and found to play a vital role in influencing survival for pediatric IFS. Early diagnosis, prompt medical therapy, and aggressive surgical intervention remain at the forefront in the treatment of this complex opportunistic infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 133:1239\u20131250, 2023<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30310","type":"journal-article","created":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T09:46:48Z","timestamp":1658742408000},"page":"1239-1250","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Pediatric Invasive Fungal Rhinosinusitis: A Comprehensive Analysis of Prognostic Factors for Survival"],"prefix":"10.1002","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8145-1721","authenticated-orcid":false,"given":"Vijay A.","family":"Patel","sequence":"first","affiliation":[{"name":"Division of Otolaryngology \u2010 Head and Neck Surgery Children's Hospital Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher D.","family":"LePhong","sequence":"additional","affiliation":[{"name":"Department of Pathology Children's Hospital Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2774-3229","authenticated-orcid":false,"given":"Beth","family":"Osterbauer","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology \u2010 Head and Neck Surgery Children's Hospital Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Gomez","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology \u2010 Head and Neck Surgery Children's Hospital Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra M.","family":"Don","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology \u2010 Head and Neck Surgery Children's Hospital Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4177-6716","authenticated-orcid":false,"given":"Elisabeth H.","family":"Ference","sequence":"additional","affiliation":[{"name":"Caruso Department of Otolaryngology\u2010Head &amp; Neck Surgery University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian J.","family":"Hochstim","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology \u2010 Head and Neck Surgery Children's Hospital Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffery A.","family":"Koempel","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology \u2010 Head and Neck Surgery Children's Hospital Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-018-2722-0"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2016.09.019"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2019.109734"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2017.05.015"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.3109\/08880018.2015.1092058"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2005.04.014"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2012.06.021"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otorri.2018.09.001"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/pis042"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0000000000000507"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000001015"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/014556139507400811"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459989110500608"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.28676"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2018.09.019"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2015.10.015"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(83)80774-4"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23912"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2017.31.4420"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2017.09.009"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.30310","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.30310","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.30310","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T04:05:43Z","timestamp":1692677143000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.30310"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,25]]},"references-count":21,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,5]]}},"alternative-id":["10.1002\/lary.30310"],"URL":"https:\/\/doi.org\/10.1002\/lary.30310","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,25]]},"assertion":[{"value":"2022-02-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}