Mycosis of the maxillary sinuses

Abstract

Fungus infection of the maxillary sinus has been considered a rare disorder; recently, however, such cases have been reported in increasing number. The authors have recently observed five cases of mycosis of the paranasal sinuses. Three of these cases showed the clinical symptoms and signs of swelling and pain in the cheek area and epistaxis and aroused suspicion of maxillary cancer. Of the remaining two cases one was misdiagnosed as maxillary cancer with pulmonary metastasis and radiation therapy without preliminary tissue diagnosis given because of the poor general condition of the patient. On improvement of the patient's condition exploratory maxillotomy and mucosal biopsy revealed mycotic invasion; in the other, chronic bacterial maxillary sinusitis was suspected, but exploratory sin‐usostomy showed mycosis. The authors emphasize an apparent increasing frequency of mycosis of the paranasal sinuses and the fact that the symptoms and signs of mycotic invasion may duplicate those of early malignancy of this area.

Non-invasive antromycosis (Diagnosis and treatment)

“…Many antimycotic agents have been used e.g. Mysteclin V and Mycostatin systemically; and Trichomycin, phenylmercuric acetate and Pigment locally (Iwamoto et al, 1972); amphotericin B for invasive mycotic infections (Jahrsdoerfer et al, 1979); flucytosine, miconazole nitrate and phenformin hydrochloride (Dworzack et ah, 1978). We instilled clotrimazole locally after repeated antral washouts or following a Caldwell-Luc operation.…”

“…Since then, 103 cases have been reviewed in the world literature, by Jahrsdoerfer et al (1979); and in the Sudan, 63 more cases of antral aspergillosis have been reported, by Milosev et al, (1969) and by Veress et al (1973). Iwamoto et al (1972) reported five cases of mycotic maxillary sinusitis, and identified by histopathology one case of Candida and one of Mucoraceae. In 1977, Gluckman et al described the first case of Petriellidium (Allescheria) boydii obtained from the maxillary antrum of an elderly diabetic chronic alcoholic man; a second case was reported by Bark et ah, (1978), and a third, causing sphenoidal sinusitis, by Mader et al (1978).…”

Aspergillus sinusitis

“…There is a third factor which seems important to the authors, namely that mechanical obstruction of the nasal and/or sinus cavity prevents adequate drainage. The clinical presentation of Aspergillus sinusitis is not pathognomonic: Iwamoto, Katsura andFujimki (1972), Taillens et al (1970), Grigoriu, Bambule and Delacretaz (1975), Grigoriu and Bambule (1976), Bambule, Grigoriu and Savary (1978) have all pointed out the need for a differential diagnosis for sinus cavity tumours.…”

La sinusite maxillaire fongique

“…La symptomatologie clinique de la SMF est peu spécifique, elle se con fond avec celle de la sinusite maxillaire chronique [1][2][3]. A la sinusoscopie on constate: 1) Une muqueuse fortement enflammée avec un écoulement muco purulent.…”

“…3) Les formes pseudo-tumorales sont souvent confondues avec un néo plasme [1,3], d'où la nécessité lors de toute opération, de pratiquer, à part l'examen histologique, un examen mycologique complet.…”