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Decoding the Complexity: A Case Series on Isolated Sphenoid Sinus Fungal Ball.

A R Babu¹, T M Amulya¹, D Sandhya¹

¹Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India.

Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India

|August 12, 2024

Summary

Fungal balls in the sphenoid sinus, though rare, can cause significant symptoms like headaches. Endoscopic sphenoidotomy offers a safe and effective surgical solution, with no recurrence observed in this study.

Keywords:

Endoscopic sphenoidotomy Fungal ball Fungal rhinosinusitis Sphenoid sinus

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Area of Science:

Otolaryngology
Mycology
Surgical Pathology

Background:

Fungal rhinosinusitis is a common paranasal sinus disease, with fungal balls being the most frequent presentation.
While typically affecting the maxillary sinus, fungal balls can occur in the sphenoid sinus (24.78% of cases), posing unique management challenges due to anatomical proximity to critical structures.

Purpose of the Study:

To evaluate the efficacy of trans-nasal sphenoidotomy for treating isolated fungal balls in the sphenoid sinus.
To assess postoperative outcomes, including recurrence and symptom resolution.

Main Methods:

Retrospective analysis of patients diagnosed with isolated sphenoid sinus fungal balls.
Surgical intervention via endoscopic trans-nasal sphenoidotomy.
Postoperative follow-up for recurrence or residual disease.

Main Results:

Four cases of isolated sphenoid sinus fungal ball were identified.
Headache was the predominant presenting symptom.
All patients underwent successful endoscopic surgery without complications, and no recurrence or residual disease was noted during follow-up.

Conclusions:

Fungal ball in the sphenoid sinus, despite diagnostic challenges, is effectively managed with endoscopic sphenoidotomy.
Early detection and surgical intervention are crucial for successful treatment and prevention of complications.
Symptomatic relief, particularly of headaches, was achieved post-surgery.