Isolated frontal sinus fungus ball: Diagnostic and therapeutic features and the role of endonasal endoscopic approach |
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| Authors: | Ines Kharrat Mohamed Amin Chaabouni Rania Kharrat Wadii Thabet Boutheina Hammami Imen Achour Ilhem Charfeddine |
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| Affiliation: | 1. Department of Clinical Microbiology, Christian Medical College and Hospital, Vellore, India;2. Department of Medicine, Christian Medical College and Hospital, Vellore, India;3. Department of Pulmonary Medicine, Christian Medical College and Hospital, Vellore, India;4. Department of Nephrology, Christian Medical College and Hospital, Vellore, India;5. Department of Infectious Diseases, Christian Medical College and Hospital, Vellore, India;6. Department of Hematology, Christian Medical College and Hospital, Vellore, India;1. Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia;2. Department of General and Digestive Surgery, Habib Bourguiba University Hospital, University of Sfax, Tunisia;1. Department of Stomatology, School of Dentistry - University of São Paulo, Av. Lineu Prestes, São Paulo 2227, Brazil;2. Department of Maxillofacial Surgery, Prosthetics and Traumatology, School of Dentistry - University of São Paulo, Av. Lineu Prestes, São Paulo 2227, Brazil;3. Department of Dermatology, School of Medicine - University of São Paulo, Av. Dr. Arnaldo, São Paulo 455, Brazil;1. Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran;2. Student Research Committee, Iran University of Medical Sciences, Tehran, Iran;3. Department of Mycology, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran;4. Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran;1. Department of Hematology, LHUB-ULB (Laboratoire Hospitalier Universitaire de Bruxelles), Rue Haute 322, Brussels 1000, Belgium;2. Department of Infectious Diseases, Saint-Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium;3. Department of Microbiology, Immunology and Transplantation, KU Leuven and Clinical Department of Laboratory Medicine and National Reference Center for Mycosis, University Hospitals Leuven, Leuven, Belgium;4. Department of Pathology, Institut Jules Bordet, Brussels, Belgium;5. Department of Microbiology, LHUB-ULB (Laboratoire Hospitalier Universitaire de Bruxelles), Brussels, Belgium;1. Department of Medical Laboratory Technology, Faculty of Health Sciences, Beirut Arab University, Tripoli, Lebanon;2. Laboratory of Clinical Bacteriology and Mycology, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium;3. Department of Laboratory Medicine and National Reference Center for Mycosis, Excellence Center for Medical Mycology (ECMM), University Hospitals Leuven, Leuven, Belgium;4. Center for Infection and Immunity of Lille, University of Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL, Lille F-59000, France;5. CHU Lille, Laboratoire de Parasitologie-Mycologie, Lille F-59000, France |
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| Abstract: | Fungus ball (FB) is a non invasive form of fungal sinusitis that generally affects immunocompetent subjects. Isolated involvement of the frontal sinus is extremely rare. The treatment is surgical. Previously, it was based on the external approach. Recently, the endoscopic approach has been increasingly employed.We report three cases of frontal sinus fungus ball. Two patients underwent endoscopic endonasal frontal Draf type IIb sinusotomy with complete removal of the pathologic material. The third patient had an external approach due to the extensive pneumatisation of the frontal sinus, the defect in its floor and the orbital involvement. There were no intraoperative or postoperative complications. No recurrence of the disease was observed during the three, two and twelve months’ follow up period, respectively.Correct clinical and radiological diagnosis of isolated frontal sinus FB still remains a challenge. Endoscopic sinus surgery with endonasal Draf type IIb or type III frontal sinusotomy is effective for the treatment of frontal sinus FB. It is the treatment of choice and replaces the traditional external approaches. |
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| Keywords: | Frontal sinus Sinusitis/diagnostic imaging Endoscopy/surgery Fungal structures Aspergillus |
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