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Assessment of the necessity of frontal sinostomy in cases of frontal sinusitis associated with fungus ball of the maxillary sinus

  • Rhinology
  • Published:
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Abstract

Purpose

This study was conducted to evaluate outcomes in patients presenting with fungus ball of the maxillary sinus (MSFB) and frontal sinusitis who were treated via middle meatal antrostomy alone.

Methods

This was a randomized, controlled study with a parallel group design. Patients with MSFB and frontal sinusitis were randomly assigned to the maxillary middle meatal antrostomy (MMMA) or control (MMMA + frontal sinusotomy) groups. Patient demographics, complaints, imaging findings were analyzed, and surgical outcomes were evaluated using the Lund–Kennedy endoscopic score (LKES) and the 22-item Sino-Nasal Outcome Test (SNOT-22) questionnaire.

Results

In total, 40 patients were separated into two groups, with similar symptoms including nasal obstruction, mucopurulent rhinorrhea, maxillary or frontal pain, blood stained nasal discharge, nasal cacosmia and orbital pain being observed in both groups. Total LKES and SNOT-22 scores were significantly improved in both groups at 6 months post-treatment, with no significant differences in these scores between groups within a mean 6.8-month follow-up.

Conclusion

These results suggest that frontal sinusotomy is not required to resolve frontal sinusitis associated with MSFB. As such frontal sinusitis appears to be a reactive process caused by fungal ball obstruction, it regresses spontaneously following fungus ball removal, drainage of the maxillary sinus, and middle meatal antrostomy.

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Data availability

The datasets used or analysed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Funding

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Authors and Affiliations

  1. Department of Otorhinolaryngology Head and Neck Surgery, First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei, 230022, Anhui, China

    Dong Wang, Yichen Li, Hongting Hua, Yi Zhao, Chao-bing Gao & Ping Fang

Authors
  1. Dong Wang
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  2. Yichen Li
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  3. Hongting Hua
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  4. Yi Zhao
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  5. Chao-bing Gao
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  6. Ping Fang
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by DW, YL, HH, YZ, CbG and PF. The first draft of the manuscript was written by DW and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ping Fang.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This prospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The First Affiliated Hospital of Anhui Medical University approved this study.

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Informed consent was obtained from all individual participants included in the study.

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Patients signed informed consent regarding publishing their data and photographs.

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Wang, D., Li, Y., Hua, H. et al. Assessment of the necessity of frontal sinostomy in cases of frontal sinusitis associated with fungus ball of the maxillary sinus. Eur Arch Otorhinolaryngol 279, 1885–1890 (2022). https://doi.org/10.1007/s00405-021-06933-z

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  • DOI: https://doi.org/10.1007/s00405-021-06933-z

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