Sinus fungal ball at Warinchamrab hospital
Abstract
Abstract
Background: Paranasal sinus fungal ball is a non-invasive fungal rhinosinusitis occurring in immunocompetent patients, typically presenting with a unilateral lesion.
Objectives: The aim of this study was to collect data on sinus fungal balls at Warinchamrab Hospital, including their incidence, symptoms, CT scan results, pathological findings, and surgical techniques.
Methods: This retrospective case series study included patients who underwent endoscopic sinus surgery (ESS) at Warinchamrab Hospital between January 1, 2017, and December 31, 2024. Patient charts were reviewed to collect general data, preoperative CT scan results (paranasal sinus or CT brain), and histopathologic diagnoses.
Results: Thirty-five patients were analyzed, with 62.9% being female. The mean age of the patients was 60 years. The most common symptom was nasal obstruction (54.3%). The most common comorbidity was hypertension (40%). The disease most often presented as a unilateral lesion (94.3%). The maxillary sinus was the most commonly involved (80%), followed by the sphenoid sinus (17.1%). CT scans showed sclerotic bone changes in 94.3%, calcifications in 71.4% and complete opacity of sinus in 71.4%. Histopathologic examinations revealed Aspergillus in 60% of cases and Mucormycosis in 5.7%.
Conclusion: A middle-aged female predominance was noted in paranasal sinus fungal balls. The disease typically affects immunocompetent patients and most often presents as a unilateral lesion. Preoperative evaluation included nasal endoscopy and CT scans. ESS was the treatment of choice. The prognosis for sinus fungal balls is favorable, and no antifungal therapy is necessary post-surgery. The reported recurrence rate in this study was 0%. Follow-up with nasal endoscopic examination is recommended.
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