fungal infection of the sinus and anterior skull base

abstract background: invasive fungal infection is an opportunistic infection caused commonly by mucoraccae and aspergillus. it mostly occurs in patients with underlying disease. since it has a high mortality and morbidity rate, considering a treatment strategy seems necessary.   objective: since there has not been a clear protocol for treating these patients, we decided to establish a protocol for fungal infection of sinus and anterior skull base management. methods: this retrospective and descriptive case study series included 30 patients. after confirming the pathogen, the authors came to a proper protocol for treatment which is mentioned later. results: the site involvement included nose and orbital cavity (53.3%), anterior skull base and brain in conjunction with sinonasal (36.6%) and simple nasal cavity involvement (10%). 86.6% of the patients had underlying diseases. 56.6% of patients had diabetes as a single underlying disease, while 13.3% had both diabetes and renal failure in combination. acute lymphocytic leukemia was present in 6.6%, renal failure in 3.3%, lupus in 3.3% and chronic lymphocytic leukemia in 3.3% of patients. mortality rate was 40%. we categorized the patients into 3 groups: only sinonasal, sinonasal and orbit, and associated anterior skull base and brain involvement. conclusion: early diagnosis is an important factor in improving survival. anterior skull base and brain involvement has a very poor prognosis.