Dredging — a conservative approach for multiple keratocystic odontogenic tumour in Gorlin–Goltz syndrome: report of two cases

Abstract

Background: Aspergillosis was first described 300 years ago by botanist Antonio Micheli. Main species causing disease include Aspergillus fumigatus and Aspergillus flavus. In Sudan, there is a rising and spreading emergence of disease with an occupational/living hazards where prevalence is high amongst rural and farmland communities. However, recent trends suggest an immunocompetent pattern of spread in urban situated patients, compared to the classical respiratory form of disease. Objectives: We identify spread, referral patterns, patient groups, investigative methods, clinical presentations, recurrence risks and concepts of treatment approach: (a) To improve prognosis outcomes amongst our patients. (b) To increase awareness of presentation, investigative and diagnostic difficulties that can occur. Methods: Retrospective study on (n = 87) patients with head and neck Aspergillosis in Sudan. Oral and maxillofacial surgeon and mycologist are the mainstay practitioners. Otolaryngologist, eye surgeon and neurosurgeon are enrolled in the team according to extension of pathology. Results: A rising pattern of the disease emerges in immunocompetent patients (51/87 of patients are immunocompetent), diagnosis is often delayed (30%) and there is a high risk of recurrence amongst patients treated initially by endoscopic surgery (22/87 patients). Content of invasive aspergillosis found to be hard in cases with orbital and intracranial extension or granulomatous and mucoid in sinonasal lesion. Conclusions: Aspergillosis is a neglected disease with limited literature and focus on its presentation and treatment is required. We discuss multidisciplinary methods of improving diagnostics including audit procedures and a national registry setup on the treatment of head and neck aspergillosis.