Transcutaneous Retrobulbar Amphotericin B Injection for Invasive Fungal Sinusitis with Orbital Involvement: A Systematic Review.

Autor:	Abdulbaki H; School of Medicine, University of California-San Francisco, San Francisco, CA, USA., Callander JK; Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, CA, USA., Fastenberg JH; Department of Otolaryngology-Head and Neck Surgery, Northwell Health, Donald and Barbara Zucker School of Medicine, Hempstead, NY, USA., Russell MS; Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA., Vagefi MR; Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, USA., Kersten RC; John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA., Loftus PA; Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, CA, USA.
Jazyk:	angličtina
Zdroj:	American journal of rhinology & allergy [Am J Rhinol Allergy] 2024 Sep; Vol. 38 (5), pp. 339-353. Date of Electronic Publication: 2024 May 21.
DOI:	10.1177/19458924241254422
Abstrakt:	Background: Orbital involvement of invasive fungal sinusitis (IFS) is an ominous prognostic marker that should prompt rapid intervention. Transcutaneous retrobulbar administration of amphotericin B (TRAMB) is an off-label adjunctive treatment that can increase drug penetrance into diseased orbital tissue. To date, there is a lack of consensus regarding the use of TRAMB for treatment of IFS with orbital involvement. Objective: This systematic review aims to synthesize the indications, efficacy, and potential complications of TRAMB. Methods: PubMed, EMBASE, and Web of Science databases were probed for systematic review. Article search was conducted through June 2023 using the keywords "invasive fungal sinusitis," "invasive fungal rhinosinusitis," "rhino-orbital mucormycosis," "rhinosinusitis," "orbital," "retrobulbar," and "amphotericin." Results: In suitable cases as determined by radiologic and clinical evaluation, TRAMB administration has the potential to improve orbital salvage rates and improve versus stabilize visual acuity. Treatment complications are more likely with deoxycholate than with liposomal amphotericin formulations. The existing literature describing use of TRAMB is limited due to its retrospective nature, but the increase in IFS cases since 2020 due to the COVID pandemic has broadened the literature. Conclusions: TRAMB is an effective adjunctive treatment in IFS with mild-to-moderate orbital involvement when used in combination with standard of care debridement, systemic antifungal therapy, and immunosuppression reversal. Prospective longitudinal studies and multi-institutional randomized trials are necessary to determine the definitive utility of TRAMB.
Databáze:	MEDLINE
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