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Clinicopathologic characteristics of paranasal sinus fungus ball: retrospective, multicenter study in Korea
Dae Woo Kim1, Yong Min Kim2, Jin-Young Min3
1Department of Otolaryngology-Head and Neck Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, South Korea.
Purpose:
Fungus ball (FB) is the most common type of fungal rhinosinusitis and the prevalence of FB has increased over the past 10 years. The aim of this study was to compare the clinical characteristics of Korean adult patients with FB and chronic rhinosinusitis (CRS) without FB.
Methods:
We retrospectively analyzed data on 1362 patients (147 FB and 1215 CRS) who underwent endoscopic sinus surgery at nine Korean medical centers in 2005, 2010, and 2016. We evaluated the prevalence of FB and compared the clinical characteristics of FB and CRS. Medical records, computed tomography (CT) findings, atopic status, concomitant diseases, tissue, and blood eosinophil count were assessed.
Results:
The prevalence of FB was significantly higher in 2016 (15.9%) than in the other years (7.8% in 2005 and 7.5% in 2010). The FB patients were more likely to be female, older, have unilateral disease and less likely to have allergy compared to the CRS patients. The most common main complaint related to CRS and FB was nasal obstruction. CT determined that unilateral disease and maxillary sinus dominancy were common in patients with FB. The incidence of concomitant diseases was much higher in FB, with lower tissue and blood eosinophilia.
Conclusion:
FB is commonly encountered in older women with the increased prevalence. FB had a different clinical presentation, radiological findings, and prognosis than CRS. Further studies are needed to understand the pathophysiologic mechanisms underlying the development of FB.
Insights
Fungus ball (FB), a common fungal rhinosinusitis, is increasingly seen in older women. This study found FB presents differently than chronic rhinosinusitis (CRS) in clinical and radiological aspects.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Medical Mycology
Background:
- Fungus ball (FB) is the most prevalent form of fungal rhinosinusitis, with a notable rise in incidence over the last decade.
- Understanding the distinct clinical profiles of FB compared to chronic rhinosinusitis (CRS) without FB is crucial for accurate diagnosis and management.
Purpose of the Study:
- To compare the clinical characteristics of Korean adult patients diagnosed with FB versus those with CRS without FB.
- To analyze the changing prevalence of FB over time.
Main Methods:
- Retrospective analysis of 1362 patients (147 FB, 1215 CRS) undergoing endoscopic sinus surgery across nine Korean centers in 2005, 2010, and 2016.
- Evaluation included medical records, computed tomography (CT) findings, atopic status, concomitant diseases, and eosinophil counts (tissue and blood).
Main Results:
- Fungus ball prevalence significantly increased by 2016 (15.9%) compared to 2005 (7.8%) and 2010 (7.5%).
- FB patients were more frequently female, older, and presented with unilateral disease, unlike CRS patients who were more often allergic.
- Nasal obstruction was the primary complaint for both FB and CRS. FB cases showed unilateral disease and maxillary sinus dominance on CT, with higher rates of concomitant diseases but lower eosinophilia.
Conclusions:
- Fungus ball is increasingly diagnosed in older women and exhibits distinct clinical presentations, radiological findings, and prognoses compared to CRS.
- Further research is warranted to elucidate the underlying pathophysiological mechanisms of FB development.
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