Paranasal sınus fungus balls : our experıence of 19 cases and Revıew of lıterature

Main Article Content

çiğdem fırat koca Yüksel Toplu

Abstract

Introduction: Fungal sinusitis is a common  disease and increasingly getting high incidence. It forms approximately  10 % of the patients requiring surgery for the nose and the sinuses. Fungal sinusitis can be mainly categorized into invasive and non-invasive types.


Objectives: Sinus fungus ball is the most common form of fungal sinusitis. The aim of this study is to share our experience on patients diagnosed with fungus ball.


Materials-Methods: The epidemiological data, clinical presentations, radiology, mycology and histology results of 19 patients (6 males and 13 females, age between 22 to 67)  diagnosed with a fungus ball sinusitis who underwent functional endoscopic sinus surgery . All patients underwent preoperative  computed tomography  and were  evaluated  with rigid  endoscopy. Paranasal CT scan was performed in all patients and various opacities were observed.


Results: In 47 % the maxillar sinus (9 patients), in 15 % the ethmoidal cells (3 patients), in 32 % the sphenoid sinus (6 patients) and in 6 % concha bullosa (1 patient) were affected. FESS  was performed  under general anaesthesia. The diagnosis is based on histological examination of surgically removed material. Surgically removed materials were sent to the bacteriology/mycology laboratory  and the histopathology laboratory for fungal cultures and histological examination.


Conclusion: By reviewing 19 patients diagnosed with fungus ball after endoscopic surgery during the past 5 years, we report the clinical features along with a literature review.

Keywords: Fungus ball, rhinosinusitis, paranasal sinuses

Article Details

How to Cite
FIRAT KOCA, çiğdem; TOPLU, Yüksel. Paranasal sınus fungus balls : our experıence of 19 cases and Revıew of lıterature. Medical Research Archives, [S.l.], v. 6, n. 3, mar. 2018. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/1716>. Date accessed: 20 apr. 2024. doi: https://doi.org/10.18103/mra.v6i3.1716.
Section
Research Articles

References

1. Dufour X, Kauffmann-Lacroix C, Ferrie JC, Goujon JM, Rodier MH, Klossek JM . Paranasal sinus fungus ball: epidemiology, clinical features and diagnosis. A retrospective analysis of 173 cases from a single medical center in France, 1989-2002. Med Mycol. 2006; 2:61-7. ( Pubmed:16805094)
2. Kim JS, So SS, Kwon SH .The increasing incidence of paranasal sinus fungus ball: A retrospective cohort study in two hundred forty-five patients for fifteen years. Clin Otolaryngol. 2017; 42:175-9. (Pubmed:26576036)
3. Ferguson BJ. Fungus balls of the paranasal sinuses. Otolaryngol Clin North Am. 2000; 2:389-98. (Pubmed: 10736412)
4. Chao TK. Triple discrete fungus balls of the paranasal sinuses. Otolaryngol Head Neck Surg. 2004; 131:1014-5. (Pubmed : 15577809)
5. Klossek JM, Serrano E, Peloquin L. Functional endoscopic sinus surgery and 109 mycetomas of paranasal sinuses. Laryngoscope. 1997; 107:112-7. (Pubmed: 9001274)
6. Lai JC, Lee HS, Chen MK, Tsai YL. Patient satisfaction and treatment outcome of fungus ball rhinosinusitis treated by functional endoscopic sinus surgery. Eur Arch Otorhinolaryngol. 2011; 268:227-30. (Pubmed: 20535488)
7. Zhang J, Li Y, Lu X, Wang X, Zang H, Wang T et al. Analysis of fungal ball rhinosinusitis by culturing fungal clumps under endoscopic surgery. Int J Clin Exp Med. 2015; 15;8:5925-30. (Pubmed:26131186)
8. Grosjean P, Weber Rm. Fungus balls of the paranasal sinuses: a review. Eur Arch Otorhinolaryngol. 2007; 264:461-70. (Pubmed: 17361410)
9. Xu R, Ma L, Shi J, Wen W, Chen H, Li T et al. Endoscopic sinus surgery for fungal ball rhinosinusitis in South China: long-term results and analysis of prognostic factors. Acta Otolaryngol. 2012; 132:519-24. (Pubmed:22216898)
10. Nicolai P, Lombardi D, Tomenzoli D, Villaret AB, Piccioni M, Mensi M et al. Fungus ball of the paranasal sinuses: experience in 160 patients treated with endoscopic surgery. Laryngoscope. 2009; 119:2275-9.(Pubmed:19688860)
11. Beck-Mannagetta J, Necek D, Grasserbauer M. Zahnaerztliche Aspekte der solitaeren Kieferhoehlen-Aspergillose. Eine klinische, mikroanalystische und experimentelle untersuchung. Z Stomatol. 1986; 83:283-315.
12. Odell E, Pertl C. Zinc as a growth factor for Aspergillus sp. and the antifungal effect of root canal sealants. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995; 79:82-7. (Pubmed: 7614168)
13. Willinger B, Beck-Mannagetta J, Hirschl AM, Markristathis A, Rotter ML. Influence of zinc-oxide on Aspergillus species: a poissible cause of local, non invasive aspergillosis of the maxillary sinus. Mycoses. 1996; 39:361-6. (Pubmed:9009659)
14. Mensi M, Salgarello S, Pinsi G, Piccioni M. Mycetoma of the maxillary sinus: endodontic and microbiological correlations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 98:119-23. (Pubmed:15243482)
15. Nomura K, Asaka D, Nakayama T, Okushi T, Matsuwaki Y, Yoshimura T et al. Sinus fungus ball in the Japanese population: clinical and imaging characteristics of 104 cases. Int J Otolaryngol. 2013;731640. (Pubmed: 24324499)
16. Kim S.W, Park Y.J, Kim S.W. et al. A Clinical Analysis of Fungal Sinusitis. Korean. J. Otolaryngol-Head Neck Surg. 2005; 48:332-7.
17. Chobillon MA, Jankowski R. What are the advantages of the endoscopic canine fossa approach in treating maxillary sinus aspergillomas? Rhinology. 2004; 42:230-5. (Pubmed:15626257)
18. Dufour X, Kauffmann-Lacroix C, Ferrie J-C. Paranasal sinus fungus ball and surgery: a review of 175 cases. Rhinology. 2005; 43:34-9.( Pubmed :15844500)
19. Ferreiro JA, Carlson BA, Cody DT. Paranasal sinus fungus balls. Head Neck. 1997; 19:481-6. (Pubmed:9278755)
20. Toplu Y, Toplu SA, Can S, Kuzucu C. Fungus ball in concha bullosa: an unusual cause of retro-orbital pain. J Craniofac Surg. 2014; 25:138-40. (Pubmed: 24621753)
21. Ledderose GJ, Braun T, Betz CS, Stelter K, Leunig A. Functional endoscopic surgery of paranasal fungus ball: clinical outcome, patient benefit and health-related quality of life. Eur Arch Otorhinolaryngol. 2012; 269:2203-8. (Pubmed:22249836)
22. Han DH, An SY, Kim SW, Kim DY, Rhee CS, Lee CH, et al. Primary and secondary fungal infections of the paranasal sinuses: clinical features and treatment outcomes.
Acta Otolaryngol Suppl. 2007;558:78-82. (Pubmed :17882575)