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Published on: January 17, 2018
Sphenoid sinus fungus ball: our experience
Fabio Pagella1, Alessandro Pusateri, Elina Matti
1Department of Otorhinolaryngology, Laboratori Sperimentali di Ricerca, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, University of Pavia, Pavia, Italy. tpagella@libero.it
American Journal of Rhinology & Allergy
|August 9, 2011
Summary
Sphenoid sinus fungus balls (SSFB) are uncommon but can cause symptoms like headaches. Direct paraseptal sphenoidotomy is recommended as a minimally invasive surgical approach for SSFB treatment.
Area of Science:
- Otolaryngology
- Mycology
- Surgical Innovation
Background:
- Fungal rhinosinusitis is a common paranasal sinus disease.
- Fungus ball (FB) is an extramucosal mycotic proliferation.
- Sphenoid sinus localization of FB is rare.
Purpose of the Study:
- To describe the diagnosis and treatment of sphenoid sinus fungus ball (SSFB).
- To focus on the surgical approach for SSFB.
Main Methods:
- Retrospective analysis of 226 patients undergoing endoscopic sinus surgery (ESS) from 1995-2009.
- Detailed description of surgical techniques, mycological, and histopathological evaluations.
- Review of perioperative and postoperative management.
Main Results:
- 56 patients (24.78%) had SSFB, with a mean age of 62 years.
- Cephalea (headache) was the most common symptom (14.3% had ocular symptoms).
- Direct paraseptal sphenoidotomy (55.4%) and transethmoidal sphenoidotomy (44.6%) were performed; Aspergillus fumigatus was the most common fungus.
Conclusions:
- A precise diagnostic pathway is crucial for sphenoidal diseases.
- Direct paraseptal sphenoidotomy is considered the least invasive, fastest, and most anatomically conservative surgical approach for SSFB.
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