Skip to main content
SpringerLink
Log in

The Combined Middle and Inferior Antrostomy for Fungal Maxillary Sinusitis Treatment

  • Original Article
  • Published:
Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Aims: The objective of this study is to assess the effectiveness of the combined middle and inferior meatal antrostomy (MIMA) in management of patients with maxillary fungal sinusitis. Material and Methods: Design: retrospective cross sectional study. Setting and subjects: From September 2018 to March 2021, fifty-five patients with non-invasive maxillary fungal sinusitis, who underwent transnasal endoscopic combined MIMA. Methods: The study compared patients’ pre- and post-operative subjective symptoms, including nasal obstruction, discharge, facial pain or pressure, halitosis, anosmia, and other non-specific symptoms. Endoscopic characteristics of recurrent fungal maxillary sinusitis and postoperative complications were also observed. Closure of the IMA site was evaluated at three and six months post-surgery and patients were categorized into three groups based on closure degree. Results: All clinical symptoms, including nasal discharge, nasal obstruction, nasal pruritus, anosmia, halitosis, sneezing, facial pain, ophthalmic and otologic symptoms, were resolved over six months after combined MIMA in majority of cases (94 − 100%). After three and six months, the postoperative endoscopic evaluation revealed recurrent fungal maxillary sinusitis in 1.8% and 5.4% of cases, respectively. Partial stenosis of the inferior antrostomy was observed in 7.2% and 16% of cases, while complete stenosis was noted in 3.6% and 7.2% of cases after three months and six months. Conclusions: The combined MIMA is effective and has better outcomes than the medial meatal antrostomy approach alone without additional operative time.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Data Availability

All data generated or analyzed during this study are included in this article.

References

  1. Chakrabarti A, Denning DW, Ferguson BJ, Ponikau J, Buzina W, Kita H, Marple B, Panda N, Vlaminck S, Kauffmann-Lacroix C et al (2009) Fungal rhinosinusitis. Laryngoscope 119:1809–1818

    Article  PubMed  PubMed Central  Google Scholar 

  2. Deshazo RD (1998) Fungal sinusitis. Am J Med Sci 316:39–45

    CAS  PubMed  Google Scholar 

  3. 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

    Article  CAS  PubMed  Google Scholar 

  4. Grosjean P, Weber R (2007) Fungus balls of the paranasal sinuses: a review. Eur Arch Otorhinolaryngol 264:461–470

    Article  PubMed  Google Scholar 

  5. Pagella F, Matti E, De Bernardi F, Semino L, Cavanna C, Marone P, Farina C, Castelnuovo P (2007) Paranasal sinus fungus ball: diagnosis and management. Mycoses 50:451–456

    Article  PubMed  Google Scholar 

  6. Nomura K, Asaka D, Nakayama T, Okushi T, Matsuwaki Y, Yoshimura T, Yoshikawa M, Otori N, Kobayashi T, Moriyama H (2013) Sinus fungus ball in the japanese population: clinical and imaging characteristics of 104 cases. Int J Otolaryngol 2013:731640

    PubMed  PubMed Central  Google Scholar 

  7. Liu X, Liu C, Wei H, He S, Dong S, Zhou B, Zhang L, Li Y (2020) A retrospective analysis of 1,717 paranasal sinus fungus ball cases from 2008 to 2017. Laryngoscope 130:75–79

    Article  PubMed  Google Scholar 

  8. Kim JS, So SS, Kwon SH (2017) The increasing incidence of paranasal sinus fungus ball: a retrospective cohort study in two hundred forty-five patients for fifteen years. Clin Otolaryngol 42:175–179

    Article  CAS  PubMed  Google Scholar 

  9. Sonbay Yılmaz ND, Afyoncu C, Ensari N, Yıldız M, Gür ÖE (2021) The effect of the mother’s participation in therapy on children with vocal fold nodules. Annals of Otology Rhinology & Laryngology 130:1263–1267

    Article  Google Scholar 

  10. Sawatsubashi M, Murakami D, Umezaki T, Komune S (2015) Endonasal endoscopic surgery with combined middle and inferior meatal antrostomies for fungal maxillary sinusitis. J Laryngol Otol 129(Suppl 2):S52–55

    Article  PubMed  Google Scholar 

  11. Choi Y, Kim B-H, Kang S-H, Yu MS (2019) Feasibility of minimal Inferior Meatal Antrostomy and Fiber-Optic Sinus exam for fungal sinusitis. Am J Rhinol Allergy 33:634–639

    Article  PubMed  Google Scholar 

  12. Klossek J-M, Serrano E, Péloquin L, Percodani J, Fontanel J-P, Pessey J-J (1997) Functional endoscopic sinus surgery and 109 mycetomas of Paranasal Sinuses. Laryngoscope 107:112–117

    Article  CAS  PubMed  Google Scholar 

  13. Dufour X, Kauffmann-Lacroix C, Ferrie JC, Goujon JM, Rodier MH, Karkas A, Klossek JM (2005) Paranasal sinus fungus ball and surgery: a review of 175 cases. Rhinology 43:34–39

    PubMed  Google Scholar 

  14. Albu S, Gocea A, Necula S (2011) Simultaneous inferior and middle meatus antrostomies in the treatment of the severely diseased maxillary sinus. Am J Rhinol Allergy 25:e80–e85

    Article  PubMed  Google Scholar 

  15. Sawatsubashi M (2018) Endoscopic Surgical Procedures for Fungal Maxillary Sinusitis: how to do it, a review. Int J Otolaryngol Head Neck Surg 07:287–297

    Article  Google Scholar 

  16. Ding L, Na g, Lou Z (2022) Extended middle meatal antrostomy via antidromic extended medial wall for the treatment of fungal maxillary sinusitis. BMC Surg 22:287

    Article  PubMed  PubMed Central  Google Scholar 

  17. Lund VJ (1988) Inferior meatal antrostomy. Fundamental considerations of design and function. J Laryngol Otol Suppl 15:1–18

    Article  CAS  PubMed  Google Scholar 

  18. Tani A, Tada Y, Miura T, Suzuki T, Nomoto M, Saijo H, Ono M, Ogawa H, Omori K (2011) Surgical Approach for Maxillary Fungal Sinusitis. Nihon Bika Gakkai Kaishi (Japanese Journal of Rhinology) 50:26–30

    Article  Google Scholar 

  19. Suzuki M, Matsumoto T, Yokota M, Toyoda K, Nakamura Y (2019) Transnasal inferior meatal antrostomy with a mucosal flap for post-caldwell-luc mucoceles in the maxillary sinus. J Laryngol Otol 133:674–677

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

None.

Funding

No funding was used in this study.

Author information

Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Cho Ray Hospital, Ho Chi Minh City, 700000, Vietnam

    Cong Van Ngo

  2. Department of Foundation Science, Nova Southeastern University, The Kiran C. Patel College of Osteopathic Medicine (NSU-KPCOM), Clearwater, FL, 33025, USA

    Hoang Nguyen & Joseph Aklinski

  3. Department of Preventative Medicine, School of Medicine, University of California at Los Angeles/Charles R. Drew (UCLA), Los Angeles, CA, USA

    Hoang Nguyen

  4. Faculty of Otolaryngology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, 700000, Vietnam

    Dung My Thi Nguyen & Hoang Huy Le

  5. Cardiovascular Research Department, Methodist Hospital, Merrillville, IN 46410, USA

    Trang Thi Bich Le, Hien Quang Nguyen & Le Huu Hanh Nhi

  6. School of Biotechnology, Tan Tao University, Long An, Vietnam

    Hong-Han Huynh

  7. International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, 110, Taiwan

    Le Huu Nhat Minh

  8. Research Center for Artificial Intelligence in Medicine, Taipei Medical University, Taipei, 106, Taiwan

    Le Huu Nhat Minh

  9. Emergency Department, University Medical Center, Ho Chi Minh City, Vietnam

    Le Huu Nhat Minh

  10. Interdisciplinary and Translational Medicine Internship Training Program, College of Medical Science and Technology, Taipei Medical University, Taipei, 110, Taiwan

    Hong-Han Huynh

  11. International Master Program for Translational Science, College of Medical Science and Technology, Taipei Medical University, Taipei, 110, Taiwan

    Hong-Han Huynh

  12. Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, 700000, Vietnam

    Le Huu Hanh Nhi

Authors
  1. Cong Van Ngo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hoang Nguyen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joseph Aklinski
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Dung My Thi Nguyen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hoang Huy Le
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Trang Thi Bich Le
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hien Quang Nguyen
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hong-Han Huynh
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Le Huu Hanh Nhi
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Le Huu Nhat Minh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Le Huu Nhat Minh.

Ethics declarations

Conflict of Interest

All authors declare that they have no conflict of interest.

Ethical Approval

Ethical committee approved the study proposal.

Informed Consent

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

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Van Ngo, C., Nguyen, H., Aklinski, J. et al. The Combined Middle and Inferior Antrostomy for Fungal Maxillary Sinusitis Treatment. Indian J Otolaryngol Head Neck Surg 75, 2850–2855 (2023). https://doi.org/10.1007/s12070-023-03863-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12070-023-03863-6

Keywords

Search

Navigation