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Cranial Bones: Lateral View

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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
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Published on: January 17, 2018

Sphenoid sinus fungus ball.

Alexandre Karkas1, Raed Rtail, Emile Reyt

  • 1Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Grenoble, PO Box 217, 38043, Grenoble Cedex 9, France. akarkas@chu-grenoble.fr

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|August 2, 2012
PubMed
Summary

Sphenoid sinus fungus ball (SSFB), often caused by Aspergillus, presents with posterior rhinorrhea and headache. Endoscopic surgery effectively removes the fungus ball with low recurrence, but complications like epistaxis can occur.

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Area of Science:

  • Otolaryngology
  • Mycology
  • Radiology

Background:

  • Sphenoid sinus fungus ball (SSFB) is an uncommon condition.
  • It typically results from Aspergillus infection and can cause various symptoms if untreated.

Purpose of the Study:

  • To describe the clinical features, diagnosis, treatment, and outcomes of SSFB.
  • To evaluate the effectiveness and safety of endoscopic sphenoidotomy for SSFB.

Main Methods:

  • Retrospective study of 28 patients operated for SSFB over 14 years.
  • Diagnosis based on nasal endoscopy and CT scans; MRI used for suspected invasion.
  • Treatment involved endoscopic transnasal or transethmoidal sphenoidotomy with fungus ball removal.

Main Results:

  • Common symptoms included posterior rhinorrhea and headache; vision changes and cacosmia were less frequent.
  • Postoperative complications included epistaxis and bacterial superinfection in a few cases.
  • No recurrence was observed after a mean follow-up of 13 months.

Conclusions:

  • SSFB is an uncommon but potentially serious condition requiring prompt diagnosis and treatment.
  • Endoscopic sphenoidotomy is an effective treatment with low morbidity and recurrence rates.
  • Nasal endoscopy and CT scanning are crucial for preoperative diagnosis.