Review
. 2007 Nov;50(6):451-6.
doi: 10.1111/j.1439-0507.2007.01416.x.
Paranasal sinus fungus ball: diagnosis and management
Affiliations
Abstract
Paranasal sinus fungus ball is an extramucosal mycosis, usually
occurring in immunocompetent people as a monolateral lesion. To review
the literature data and to report the Policlinico S. Matteo, University
of Pavia experience, 81 patients presenting paranasal fungus ball have
been treated (January 1994 to May 2005). Twenty-seven men and 54 women
(19-91 years old; mean 49.4 years) were considered. Seventy-three
patients had a single sinus affected, but eight presented multiple
localisations. Maxillary was the most involved sinus followed by
sphenoidal and ethmoidal. Moulds have been isolated in 28/81 cases.
Histology showed fungal colonisation but not invasion in all cases.
Tomography showed bone erosion in 33.3% of patients. All have been
treated only by functional endoscopic sinus surgery. Seventy-seven of 81
patients have been cured. Four of 81 patients needed another surgical
treatment. Follow up was between 6 and 132 months (average: 63 months).
Fungus ball is a sinusal pathology caused by mycetes like Aspergillus
spp. Histology confirms the fungal aethiology excluding tissue invasion.
Mycological culture consented to identify the pathogenic mould in 34.5%
of cases. Actually functional endoscopic sinus surgery is the gold
standard for treatment of this pathology, and antifungal therapy is
unnecessary.
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