Aspergillus Sphenoiditis Associated with an Artificial Bone Graft Used for Transsphenoidal Surgery

Fukui, Issei; Hayashi, Yasuhiro; Kita, Daisuke; Nakanishi, Sayaka; Tachibana, Osamu

doi:10.2176/nmccrj.cr.2014-0187

Cited by 1 publication

(1 citation statement)

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“…also reported that an artificial bone graft used for sellar floor reconstruction caused Aspergillus sphenoiditis. [ 7 ] They concluded that the graft was surrounded by infected granulation tissue because it could not be covered with sinus mucosa. We usually intended to cut the suture long to prevent the knot from being untied after the surgery.…”

Section: Discussionmentioning

confidence: 99%

Aspergillus sphenoiditis growth on long cut ends of a non-absorbable sellar floor dura closure suture

Eguchi¹,

Matsuoka²,

Suzuki³

et al. 2021

Surgical Neurology International

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Background: Cerebrospinal fluid (CSF) rhinorrhea is a common complication after transsphenoidal surgery (TSS). Suturing of sellar dura is effective in the prevention of postoperative CSF rhinorrhea, but it may cause rare postoperative infections. Herein, we report a case of Aspergillus sphenoiditis with the growth noted on cut ends of a polyvinylidene fluoride (PVDF) suture used for dural closure. Case Description: A previously healthy 51-year-old woman complained of abnormal odor 5 years after TSS for null cell adenoma. A white mass in the sphenoidal sinus was detected on rhinoscopy. Fungal balls were found clustered around the ends of a PVDF suture used for dural closure at the initial surgery. She underwent removal of both the fungal ball and dural suture. The pathological diagnosis was Aspergillus hyphae. It is thought that a dural suture protruding out of the sphenoid sinus mucosa can cause Aspergillus infection even in immunocompetent patients. A rapid and accurate diagnosis followed by surgical removal of the fungal ball and follow-up with oral antimycotic drugs result in good clinical outcomes. Conclusion: It is crucial to cut short the suture end and cover it with sphenoid sinus mucosa to avoid such complications.

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Section: Discussionmentioning

confidence: 99%