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

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.