Isolated sphenoid sinus aspergillosis: report of two cases

Aspergillus fungus can be found worldwide and is the most common fungal infection of the paranasal sinuses. Despite this ubiquity, aspergillosis of the sphenoid sinus as an isolated disease in an otherwise healthy person is quite rare. We report two cases in this article: one was a 53-year-old woman who suffered from bloody postnasal drip for 2 weeks and the other a 61-year-old woman suffered from facial swelling for 2 months. Central dense areas, which are characteristic for Aspergillus sinus infection, were found on their computer tomographs. Both patients were managed by functional endoscopic sinus surgery without recurrence within the 6-month follow-up period. A survey of the reports in the literature indicated that the occurrence of isolated sphenoid sinus aspergillosis was predominantly in elderly females. Hormone changes which occur during this age might play a role in the pathogenesis of fungal infection. Treatment with an anti-fungal agent was not suggested for non-invasive aspergillosis. Instead, surgery played a major role in the treatment.