Fungus ball within a mucocele of the sphenoid sinus and infratemporal fossa: case report with radiological findings

Lee, D H; Kim, Seul-Kee; Joο, Young Eun; Lim, Sang-Chul

doi:10.1017/s002221511100260x

Cited by 10 publications

(6 citation statements)

References 9 publications

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“…To be sure that the removal of all the fungal debris is complete, it is useful to irrigate the sinus cavity with saline at high pressure as recommended by Nicolaï (24) except in case of bone erosion. Another interesting technical point is to clean the sinus cavity with a neurosurgical pledget soaked in a physiologic solution as proposed by Chao and Liu (50) . When the concretion is lateral and the sphenoid sinus well-pneumatized, we recommend a posterior ethmoidectomy in association with the sphenoidotomy using the 45° or…”

Section: Microcalcifications 10mentioning

confidence: 99%

Sphenoid sinus fungall ball: a retrospective study over a 10- year period

Eloy¹,

Grenier²,

Pirlet³

et al. 2013

Rhin

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A fungal ball consists of a dense conglomerate of fungal hyphae growing at the surface of the sinus mucosa without tissue infiltration. The maxillary sinus is by far the most commonly involved paranasal sinus cavity followed by the sphenoid sinus. The present study is a retrospective study of 25 consecutive cases treated during the last 10 years in the two hospitals be- longing to the Catholic University of Louvain (CHU Mont-Godinne and UCL Saint Luc). We report the symptomatology, the imaging and discuss the different surgical managements. We conclude that the clinician must have a high index of suspicion when dealing with a unilateral rhinosinusitis persisting despite a maximal and well conducted medical treatment. This is particularly so in elderly women when associated with facial pain and post nasal drip, particularly when the computed tomography shows an unilateral opacity of the sphenoid sinus with or without a sclerosis or an erosion of the bony walls, a polyp in the sphenoethmoidal recess or a hyperdensity mimicking a foreign body. An endonasal endoscopic sphenoidotomy is the treatment of choice in most cases, allowing good ventilation of the sinus and radical removal of all the fungal concretion. A biopsy of the sinus mucosa adjacent to fungal elements is of upmost important to confirm the non- invasiveness of the fungi within the tissue. Antifungal medication is not required in uncomplicated forms. All host factors producing some degree of immunosuppression must be corrected when present and must alert the clinician to rule out any forms of invasive disease.

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Section: Microcalcifications 10mentioning

confidence: 99%

Sphenoid sinus fungall ball: a retrospective study over a 10- year period

Eloy¹,

Grenier²,

Pirlet³

et al. 2013

Rhin

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“…1) cele is an expansile lesion of the paranasal sinuses. The coexistence of a fungus ball within a mucocele can be explained by the hypothesis that the fungus ball within the sinus causes recurrent infections, which leads to obstruction of the sinus ostium and the development of a mucocele (3).…”

Section: Case Reportmentioning

confidence: 99%

“…However, infections of paranasal sinuses, mostly bacterial, may lead to the development of pyocoeles. In contrast, sphenoid sinus fungus ball within a mucocele is extremely rare (3).…”

mentioning

confidence: 99%

RadIologIcal aspect of fungus ball wIthIn a mucocele of the sphenoId sInus

Inci

Özkan

Aksoy

et al. 2013

Journal of the Belgian Society of Radiology

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“…MR contrast enhancement, if present, is usually peripheral. Low signal could be seen in both T1 and T2 in superimposed fungal infections [16].…”

Section: Discussionmentioning

confidence: 97%

Sphenoid Sinus Mucocele with Bilateral Blindness

LN¹

2017

J Neurol Neurosurg

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Objective: We present a rare case of bilateral blindness in a young man with sphenoid sinus mucocele.Case Summary: A male patient aged 18 years presented with three weeks history of worsening headache and vomiting. There was history of blurring of vision resulting in blindness in both eyes. He did not give any history of nasal or paranasal infection or fever. On general physical examination, there was no abnormality detected. Neurological examination revealed left ptosis, bilateral dilated pupils with afferent pupillary defect and no vision in both eyes. There was evidence of left complete ophthalmoplegia. On fundoscopy, there was bilateral papilloedema. Cranial CT scan showed a homogenously isodense well delineated lesion in the sphenoid area with lateral extensions. Also, cranial MRI revealed a non-enhancing sphenoid region lesion extending to sellar, suprasellar and parasellar areas. A diagnosis of sphenoid sinus mucocele with secondary infection was suspected. He underwent a navigation-guided transnasal sphenoidotomy. On the first post operative day, there was improvement in his visual acuity and afferent pupillary response returned on the left eye. Histology is in keeping with mucocele. He was discharged on the 8th post operative day on oral antibiotics and steroids for four weeks.Result: His visual recovery has been rather slow probably due to prolonged compression of the optic nerves and optic chiasm. Conclusion:Sphenoid sinus mucocele is one of the rare causes of blindness. Early diagnosis and prompt surgical treatment improve the outcome.

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Fungus ball within a mucocele of the sphenoid sinus and infratemporal fossa: case report with radiological findings

Abstract: Although an association between a fungus ball and a mucocele is rare in the paranasal sinuses, this disease entity should be considered in the differential diagnosis of expansile, cystic sinus lesions.

Cited by 10 publications

References 9 publications

Sphenoid sinus fungall ball: a retrospective study over a 10- year period

Sphenoid sinus fungall ball: a retrospective study over a 10- year period

RadIologIcal aspect of fungus ball wIthIn a mucocele of the sphenoId sInus

Sphenoid Sinus Mucocele with Bilateral Blindness

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