Abstract
We describe the clinical and radiographic characteristics of fungus balls in the bilateral paranasal sinuses. The medical records of 8 of 245 patients with fungus balls of the bilateral paranasal sinuses between 2000 and 2010 were retrospectively reviewed. The incidence of bilateral paranasal sinus fungus balls was 3.3%. Fungus balls were located in the maxillary sinuses bilaterally in 4 cases (50%), followed by the maxillary sinus and contralateral sphenoid sinus in 3 cases (37.5%), and the sphenoid sinuses bilaterally in 1 case (12.5%). There were no predisposing anatomic variations for the occurrence of bilateral paranasal fungus balls. Although the presenting symptoms and signs were non-specific, CT findings were helpful in the diagnosis of bilateral fungus balls. Endonasal removal by an endoscopic approach was performed in all patients. No peri-operative complications or recurrences were noted. Fungus balls in the bilateral paranasal sinuses are most frequently found in the maxillary sinuses bilaterally. Because symptoms of bilateral paranasal fungus balls and findings on nasal endoscopic examination are frequently non-specific, a high index of suspicion is needed and imaging studies, such as CT, are essential to establish the correct pre-operative diagnosis.
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Dufour X, Kauffmann-Lacroix C, Ferrie JC, Goujon JM, Rodier MH, Karkas A et al (2005) Paranasal sinus fungus ball and surgery: a review of 175 cases. Rhinology 43:34–39
Nicolai P, Lombardi D, Tomenzoli D, Villaret AB, Piccioni M, Mensi M et al (2009) Fungus ball of the paranasal sinuses: experience in 160 patients treated with endoscopic surgery. Laryngoscope 119:2275–2279
Klossek JM, Serrano E, Péloquin L, Percodani J, Fontanel JP, Pessey JJ et al (1997) Functional endoscopic sinus surgery and 109 mycetomas of paranasal sinuses. Laryngoscope 107:112–117
deShazo RD, O’Brien M, Chapin K, Soto-Aguilar M, Swain R, Lyons M et al (1997) Criteria for the diagnosis of sinus mycetoma. J Allergy Clin Immunol 99:475–485
Ferreiro JA, Carlson BA, Cody DT 3rd (1997) Paranasal sinus fungus balls. Head Neck 19:481–486
Robey AB, O’Brien EK, Richardson BE, Baker JJ, Poage DP, Leopold DA (2009) The changing face of paranasal sinus fungus balls. Ann Otol Rhinol Laryngol 118:500–505
Tsai TL, Guo YC, Ho CY, Lin CZ (2006) The role of ostiomeatal complex obstruction in maxillary fungus ball. Otolaryngol Head Neck Surg 134:494–498
Legent F, Billet J, Beauvillain C, Bonnet J, Miegeville M (1989) The role of dental canal fillings in the development of aspergillus sinusitis. A report of 85 cases. Arch Otorhinolaryngol 246:318–320
Roithmann R, Shankar L, Hawke M, Chapnik J, Kassel E, Noyek A (1995) Diagnostic imaging of fungal sinusitis: eleven new cases and literature review. Rhinology 33:104–110
Yoon JH, Na DG, Byun HS, Koh YH, Chung SK, Dong HJ (1999) Calcification in chronic maxillary sinusitis: comparison of CT findings with histopathologic results. AJNR Am J Neuroradiol 20:571–574
Dufour X, Kauffmann-Lacroix C, Ferrie JC, Goujon JM, Rodier MH, Klossek JM (2006) 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 44:61–67
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Lee, D.H., Joo, Y.E. & Lim, S.C. Fungus Balls of the Bilateral Paranasal Sinuses. Indian J Otolaryngol Head Neck Surg 65 (Suppl 2), 320–323 (2013). https://doi.org/10.1007/s12070-011-0465-6
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DOI: https://doi.org/10.1007/s12070-011-0465-6