Large Fungal Ball of the Paranasal Sinuses and Nasal Cavity: Two Case Reports

Щербаков, Д. А.; Климова, Н. В.; Malysheva, Tatyana; Shcherbakova, Augul

doi:10.21103/article9(4)_cr1

Cited by 3 publications

(4 citation statements)

References 3 publications

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“…Therefore, a fungal ball was considered to be the most appropriate term [1][2][3][4]. In accordance with our observations, fungal balls frequently occur in only one sinus and the maxillary sinus is most commonly affected [1][2][3][4][5][6][8][9][10]. The reasons for this phenomenon are unknown [5].…”

Section: Discussionsupporting

confidence: 73%

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Mycotic Infection (Fungal Ball) of the Paranasal Sinuses: A Clinicopathological Observation

Bartoš

Bartošová

2020

Galician med. j.

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Mycotic infections of the nasal cavity and paranasal sinuses represent a wide spectrum of disorders that vary in clinical presentation, histopathologic appearances, and biological significance. The second most common form is a fungal ball. The objective of the research was to describe the cases of paranasal sinus fungal ball found in the files of patients with chronic rhinosinusitis. Materials and Methods. There were demonstrated clinical and histopathological data of two patients. Results. A 42-year-old woman and a 40-year-old man with chronic hypertrophic sinusitis had a large amount of friable cheesy mass in the maxillary sinus. The female patient previously underwent upper dental arch sanation. Histology revealed dense laminated masses of matted fungal hyphae that were separate from the mucosa. Sinonasal mucosa showed mild chronic inflammation (male) and severe non-specific chronic active inflammation (female). No evidence of fungal invasion in the mucosa was found. Conclusions. Fungal ball represents a non-invasive form of mycotic rhinosinusitis with favourable prognosis. Biopsy examination plays an important role in the diagnostic process. Although the diagnosis can also be achieved by polymerase chain reaction assays, biopsy is the only way to explore the status of an inflammatory damage to adjacent tissue and, thus, to rule out potential invasive mycotic sinus disease with much worse clinical outcome.

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Section: Discussionsupporting

confidence: 73%

“…The reasons for this phenomenon are unknown [5]. Typically, they occur in immunocompetent patients and are reported to be more prevalent among middle-aged and elderly females [1,3,4,6,9,10]. The pathogenesis of fungal ball formation is not completely understood [6].…”

Section: Discussionmentioning

confidence: 99%

Mycotic Infection (Fungal Ball) of the Paranasal Sinuses: A Clinicopathological Observation

Bartoš

Bartošová

2020

Galician med. j.

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“…Less common symptoms include convulsions, epistaxis, proptosis, fever, cough, and blurred vision. However, some patients may be asymptomatic [ 8 , 9 , 12 , 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…The medial wall of the involved maxillary sinus was not evaluated because the majority of cases illustrated evident erosion of the medial wall [ 18 ]. In addition, in some cases, MRI is used for diagnosing fungal ball with bony lysis and possible orbital or brain connection [ 8 , 9 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

The Endonasal Endoscopic Approach to Different Sinonasal Fungal Balls

Almomen

Albaharna

AlGhuneem

et al. 2022

International Journal of Otolaryngology

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Background. Fungal ball sinusitis is a sinonasal fungus ball that usually affects immunocompetent adults with female predominance. The most affected sinus is the maxillary sinus. Aspergillus species is the most typically found fungus. Computed tomography (CT) scan is the gold standard tool in order to diagnose fungal ball sinusitis. The ultimate method for a fungal ball is functional endoscopic sinus surgery (FESS), which has a high success rate and a low morbidity rate. Objective. This study aims to demonstrate the various clinical presentations of fungal ball sinusitis including isolated maxillary sinus, sphenoid sinus, simultaneous occurrence of maxillary and sphenoid fungal ball, and post endonasal endoscopic pituitary surgery fungal ball with various age groups. Also, this study aims to emphasize the importance of early diagnosis and treatment in such cases. Patients and Methods. A retrospective study that was carried in the otorhinolaryngology department of two hospitals: King Fahad Specialist Hospital and Qatif Central Hospital, Eastern Region, Saudi Arabia. The study was conducted on a total of 16 patients who were diagnosed with paranasal sinuses fungal ball in an 11-year period from January 2008 and November 2019. Results. Out of 16 patients with paranasal sinuses fungal ball, 11 cases were female and 5 males, with age ranging between 16 and 46 years. Results showed eight isolated sphenoid (50%), six isolated maxillary fungal ball (38%), one simultaneous occurrence of the sphenoid and maxillary fungal ball (6%), and one post endonasal endoscopic pituitary surgery for pituitary adenoma (6%). CT scan was performed for all 16 cases which is the standard tool for the diagnosis of the fungal ball. Conclusion. Fungal ball may present with variety of symptoms but most commonly with postnasal discharge (PND), headache, and facial pain. CT sinuses is the diagnostic radiological modality to confirm the diagnosis. The FESS functional endoscopic sinus surgery is the gold safe approach for patients with fungal ball to manage their symptoms, confirm the diagnosis, and removal of disease with no morbidities.

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