Paranasal sinus fungus ball: analysis of clinical characteristics and surgical outcomes

Abstract

Fungal rhino-sinusitis (FRS) can be broadly divided into two categories based on histopathological findings: invasive and non-invasive, depending on the status of the mucosal layer. The invasive diseases include (1) acute invasive (fulminant) FRS, (2) granulomatous invasive FRS and (3) chronic invasive FRS. The non-invasive diseases include (1) saprophytic fungal infestation, (2) fungal ball, and (3) fungus related eosinophilic FRS that includes allergic fungal rhinosinusitis. Invasive FRS mostly affects immuno-compromised patients, whereas the non-invasive form occurs in immunocompetent patients.[1]Fungal ball is described as the presence of non-invasive accumulation of dense conglomeration of fungal hyphae in one sinus cavity. Various terms, such as mycetoma, aspergilloma, and chronic non-invasive granuloma have been used in the literature. [1,2] Sonuç:Her olguda etkilenmifl sinüs a¤z›n›n cerrahi yolla aç›lmas› ve fungal yo¤unlu¤un ortadan kald›r›lmas› tercih edilen tedavi flekli olmufltur.Anahtar sözcükler: Paranazal mantar topu, misetom, cerrahi. AbstractObjective: The aim of the present study was to analyse the clinical, radiographic, and surgical outcomes of paranasal fungus ball. Methods:A retrospective data analysis was performed on 16 patients who underwent endoscopic sinus surgery for paranasal sinus fungus ball between December 2005 and November 2014. The patient's demographic data, clinical presentations, radiological findings and surgical outcomes were analysed.Results: There were 10 female (62.5%) and six male (37.5%) patients with a mean age of 53.6 (range: 32 to 74) years. Most common symptoms were headache and facial pain. Computed tomography showed a hyper-dense area in 12 patients (75%) and sclerosis in bony walls of the sinus in 13 patients (81.3%). Magnetic resonance imaging revealed a marked low intensity on T2 weighted images in all cases (100%). All patients were treated with functional endoscopic sinus surgery. Only one patient had a recurrence in the postoperative period. Conclusion:The surgical opening of affected sinus ostium and removal of the fungal concentration were the treatment of choice in all cases.

Non-Odontogenic Toothache Caused by the Fungal Ball of Maxillary Sinus: Case Reports

“…It occurs predominantly in older people and more frequently observed in females. The mean age of the patients www.journalomp.org was 53.6 and the ratio of female patients was 62.5% [10].…”

“…Klossek et al [11] reported that most of FB can be found in a single sinus of patients. FB is most frequently occurred in the maxillary sinus followed by the sphenoid sinus [10].…”

Paranasal fungus ball infection: Review of the literature with 15 cases

“…[5,6] Patogenezi net bilinmemektedir ancak mantar sporlarının hava yolu veya dental işlem sonucu sinüslere ulaştığını savunanlar vardır. [7] Genellikle erişkinlerde ve kadınlarda daha sık görülür.…”