Isolated Sphenoid Sinus Fungal Ball: A Case Report

Abstract

Background: Fungal rhinosinusitis is an inflammation of the paranasal sinus mucosa due to fungal infection. Fungal rhinosinusitis is classified into invasive and non-invasive forms. Non-invasive forms include fungus balls and allergic rhinosinusitis. Fungal rhinosinusitis accounts for approximately 10% of chronic rhinosinusitis cases. The maxillary sinus is most commonly affected by fungal balls, followed by the sphenoid sinus, ethmoid sinus and frontal sinus. Allergic fungal rhinosinusitis (AFRS) occurs due to an allergic and immunological response to extramucosal fungal hyphae in the sinuses.

Objective: understanding the diagnosis and management of

Isolated fungal in sphenoid.

Case Report: A woman, 32 years old, after ablation of the left inferior nasal cavity, complained of symptoms of nasal congestion for the past 2 months. The nose has been smelling since 2 months ago and the headache has been recurring since 1 month ago. On nasal endoscopic examination, necrotic tissue in 1/3 of the inferior turbinate, in the right and left nasal cavities. Computed tomography paranasal sinus scan showed a hyperdense lesion in the left sphenoid sinus. The patient was diagnosed as suffering from post ablation of the left inferior nasal cavity and rhinosinusitis et sphenoid. Surgery with an endoscopic approach was performed. Histopathology results showed chronic rhinosinusitis, acute exacerbation of fungal infection (Aspergillosis). Follow-up 9 weeks after surgery showed no recurrence

Conclusion: Symptoms include nasal congestion, anosmia, mucin production, rhinorrhea, and postnasal drop. Surgery is the first line of treatment in the management of allergic fungal rhinosinusitis. Topical corticosteroids are used as standard treatment after surgery

Keyword: allergic fungal rhinosinusitis, sphenoid, functional endoscopic sinus surgery