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Paranasal sinus fungus balls

J A Ferreiro1, B A Carlson, D T Cody

  • 1Department of Laboratory Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.

Head & Neck
|September 1, 1997
PubMed
Summary

Paranasal sinus fungus balls (mycetomas) are fungal infections affecting older adults, predominantly women. While generally low-risk, sphenoid sinus lesions pose a surgical complication risk, including fatal intracerebral bleeds.

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Area of Science:

  • Otolaryngology
  • Mycology
  • Pathology

Background:

  • Paranasal sinus fungus balls (mycetomas) are a specific type of fungal sinus infection.
  • Distinct from allergic fungal sinusitis and invasive fungal diseases.

Purpose of the Study:

  • To characterize the clinical and pathological features of paranasal sinus fungus balls.
  • To identify common pathogens and outcomes.

Main Methods:

  • Retrospective review of 29 paranasal sinus fungus ball cases from Mayo Clinic surgical pathology files (1984-1994).
  • Exclusion of allergic fungal sinusitis and invasive fungal disease cases.
  • Analysis of patient demographics, sinus involvement, causative fungi, treatment, and follow-up outcomes.

Main Results:

  • The study identified 29 cases, predominantly in women (18/29) with a mean age of 64 years.
  • Maxillary sinuses were most commonly affected (20/29), followed by sphenoid (10/29), ethmoid (9/29), and frontal (6/29).
  • Aspergillus fumigatus and Aspergillus flavus were the most frequent pathogens; surgery had a low recurrence rate (2/28), but three deaths occurred due to intracerebral bleeds, specifically in sphenoid sinus cases.

Conclusions:

  • Paranasal sinus fungus balls predominantly affect an elderly population with a female predominance.
  • These lesions generally have low morbidity and recurrence rates.
  • Surgery for sphenoid sinus fungus balls carries a risk of fatal intracerebral hemorrhage.

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