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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
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Sphenoid sinus fungal balls

James Bowman1, Benedict Panizza, Mitesh Gandhi

  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Greenslopes Private Hospital, Greenslopes, Australia.

The Annals of Otology, Rhinology, and Laryngology
|August 31, 2007
PubMed
Abstract

Insights

Fungal balls in the sphenoid sinus can expose nearby structures without increasing surgical risks. Transnasal endoscopic surgery is an effective treatment for these fungal infections.

Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Mycology

Background:

  • Fungal balls of the sphenoid sinus are uncommon infections.
  • They can potentially affect adjacent critical structures of the skull base.

Purpose of the Study:

  • To investigate the characteristics of sphenoid sinus fungal balls.
  • To assess the extent of exposure to adjacent skull base structures.
  • To evaluate the potential for surgical morbidity.

Main Methods:

  • Retrospective review of 17 cases of sphenoid sinus fungal balls.
  • Analysis of diagnosis, radiologic findings, histopathology, and surgical management.
  • Data collected between 1998 and 2005.

Main Results:

  • Exposure of the pituitary fossa, cavernous sinus, and internal carotid artery was observed.
  • No increase in perioperative complications was noted despite structural exposure.
  • Sclerotic thickening of sinus walls indicated chronic osteitis, potentially protective against erosion.
  • One case of invasive fungal disease was identified.

Conclusions:

  • Sphenoid sinus fungal balls often present with minimal symptoms, particularly in elderly patients.
  • Surgical removal is indicated.
  • Transnasal endoscopic sphenoidotomy is an effective and safe management approach with low operative morbidity.

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