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Fungal mucoceles of the sphenoid sinus
Jivianne T Lee1, Sunita Bhuta, Robert Lufkin
1Division of Head and Neck Surgery, UCLA Medical Center, Los Angeles, California 90095-1624, USA. jtlee@ucla.edu
Objective:
The purpose of this study was to demonstrate that fungal mucoceles of the sphenoid sinus do not necessarily require an external approach for eradication of disease. We report 6 cases of fungal mucoceles of the sphenoid sinus seen at UCLA Medical Center from 1980-1999, 4 of which were successfully treated with endoscopic intranasal sphenoidotomy and the other 2 through either a transseptal or transantral approach.
Study Design And Methods:
Case series. The medical records of 6 patients with fungal mucoceles of the sphenoid sinus treated at UCLA Medical Center over a 20-year period (1980-1999) were retrospectively reviewed.
Results:
Six patients diagnosed with fungal mucoceles of the sphenoid sinus were seen at UCLA Medical Center from 1980-1999. Endoscopic intranasal sphenoid sinusotomy was performed on 4 patients and a transseptal or transantral approach to the sphenoid sinus was used on the remaining 2 patients. No evidence of recurrent disease has been seen after up to 15 years of follow-up.
Conclusions:
When diagnosed early, functional endoscopic intranasal sphenoidotomy represents an effective mode of treatment for patients with fungal mucoceles of the sphenoid sinus, obviating the need for more aggressive surgical approaches.
Insights
Fungal mucoceles of the sphenoid sinus can be effectively treated using endoscopic intranasal sphenoidotomy, avoiding more invasive surgical methods. This minimally invasive technique offers a successful alternative for disease eradication.
Area of Science:
- Otolaryngology
- Endoscopic Sinus Surgery
- Mycology
Background:
- Fungal mucin balls are a common cause of chronic rhinosinusitis.
- Sphenoid sinus mucoceles can cause significant morbidity.
- Surgical management of sphenoid sinus disease has historically involved external approaches.
Observation:
- A retrospective review of 6 patients with fungal mucoceles of the sphenoid sinus treated between 1980 and 1999.
- Four patients underwent endoscopic intranasal sphenoidotomy.
- Two patients were treated with transseptal or transantral approaches.
Findings:
- Endoscopic intranasal sphenoidotomy was successful in 4 out of 6 patients.
- No recurrence of disease was observed in any patient after up to 15 years of follow-up.
- Early diagnosis facilitated effective treatment with endoscopic techniques.
Implications:
- Functional endoscopic intranasal sphenoidotomy is an effective and less invasive treatment option for fungal mucoceles of the sphenoid sinus.
- This approach can obviate the need for more aggressive external surgical procedures.
- Minimally invasive endoscopic techniques represent a paradigm shift in managing sphenoid sinus fungal mucoceles.