International Journal of Otorhinolaryngology

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Sphenoid Sinus Fungal Ball, a Tertiary Hospital Experience

Received: Mar. 11, 2020    Accepted: Mar. 25, 2020    Published: Apr. 14, 2020
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Abstract

Objective: To present the different clinical manifestations and diagnostic strategies of isolated sphenoid sinus fungal ball (SSFB), in order to prevent delayed diagnosis and providing early management. Method: This study is a retrospective clinical study, conducted between January 2008 and November 2019. It was done in the ENT department of two institutes: King Fahad specialist Hospital and Qatif Central Hospital, Saudi Arabia. Only patients with sole involvement of fungal ball in the sphenoid sinus were included. Conclusions: The incidence of isolated sphenoid fungal ball is rare. However, it's clinically important because untreated SSFB can cause significant complications. The clinical features of SSFB are ambiguous and nonspecific which make its diagnosis more difficult. Post-nasal discharge and headache refractory to the medical management are the most common symptoms of isolated sphenoid sinus lesion. CT scan is still the cornerstone of radiological diagnosis of SSFB. Endoscopic sphenoidotomy and removal of fungal debris is the standard care of management. Post-operatively, the majority of patient had good results with no complication and recurrence.

DOI 10.11648/j.ijo.20200601.14
Published in International Journal of Otorhinolaryngology ( Volume 6, Issue 1, June 2020 )
Page(s) 16-18
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Sphenoid Sinus, Fungal Ball, Non-invasive Fungal Sinusitis, Endoscopy

References
[1] Grosjean P, Weber R. Fungus balls of the paranasal sinuses: a review. Eur Arch Otorhinolaryngol. (2007) 264: 461–70. doi: 10.1007/s00405-007-0281-5.
[2] Chakrabarti A, Denning DW, Ferguson BJ, Ponikau J, Buzina W, Kita H, et al. Fungal rhinosinusitis: a categorization and definitional schema addressing current controversies. Laryngoscope (2009) 119: 1809–18. doi: 10.1002/lary.20520.
[3] Hnatuk LA, Macdonald RE, Papsin BC. Isolated sphenoid sinusitis; the Toronto Hospital for sick children experience and review of the literature. J Otolaryngol 1994; 23: 36–41.
[4] Lew D, Southwick FS, Montgomery WW, Weber AL, Baker AS. Sphenoid sinusitis. A review of 30 cases. N Engl J Med 1983; 309: 1149–54.
[5] Sethi DS. Isolated sphenoid lesions: diagnosis and management. Otolaryngol Head Neck Surg 1999; 120: 730–6.
[6] DeShazo RD, Chapin K, Swain RE (1997) Fungal sinusitis. N Eng J Med 337: 254–259.
[7] De Shazo RD, O’Brien M, Chapin K, Soto-Aquilar M, Gardner L, Swain R (1997) A new classification and diagnostic criteria for invasive fungal sinusitis. Arch Otolaryngol Head Neck Surg 123: 1181–1188.
[8] Rupa V, Jacob M, Mathews MS (2001) Increasing diagnostic yield in allergic fungal sinusitis. J Laryngol Otol 115: 636–638.
[9] Veress B, Malik OA, el-Tayeb AA, el-Daoud S, Mahgoub ES, el- Hassan AM (1973) Further observations on the primary paranasal aspergillus granulomas in Sudan: a morphological study of 46 cases. Am J Trop Med Hyg 22: 765–772.
[10] Cakmak O, Shohet MR, Kern EB. Isolated sphenoid sinus lesions. Am J Rhinol 2000; 14: 13–9.
[11] Wyllie JW, Kern EB, Djalilian M. Isolated sphenoid sinus lesions. Laryngoscope 1973; 83: 1252–65.
[12] Lawson W, Reino A. Isolated sphenoid sinus disease: an analysis of 132 cases. Laryngoscope 1997; 107: 1590–5.
[13] Martin TJ, Smith TL, Smith MM, Loehrl TA. Evaluation and surgical management of isolated sphenoid sinus disease. Arch Otolaryngol 2002; 128: 1413–9.
[14] Wang ZM, Kanoh N, Dai CF, et al. Isolated sphenoid sinus disease: an analysis of 122 cases. Ann Otol Rhinol Laryngol 2002; 111: 323–7.
[15] Lee LA, Huang CC, Lee TJ. Prolonged visual disturbance secondary to isolated sphenoid sinus disease. Laryngoscope 2004; 114: 986–90.
[16] Bardana EJ Jr (1981) The clinical spectrum of aspergillosis–part 2: classification and description of saprophytic, allergic, and invasive variants of human disease. Crit Rev Clin Lab Sci 13: 85–159.
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  • APA Style

    Ali Almomen, Hussain Albaharna, Abdullah Al Shakhs, Mohammed Alfalah, Mohammed Al Saeed, et al. (2020). Sphenoid Sinus Fungal Ball, a Tertiary Hospital Experience. International Journal of Otorhinolaryngology, 6(1), 16-18. https://doi.org/10.11648/j.ijo.20200601.14

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    ACS Style

    Ali Almomen; Hussain Albaharna; Abdullah Al Shakhs; Mohammed Alfalah; Mohammed Al Saeed, et al. Sphenoid Sinus Fungal Ball, a Tertiary Hospital Experience. Int. J. Otorhinolaryngol. 2020, 6(1), 16-18. doi: 10.11648/j.ijo.20200601.14

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    AMA Style

    Ali Almomen, Hussain Albaharna, Abdullah Al Shakhs, Mohammed Alfalah, Mohammed Al Saeed, et al. Sphenoid Sinus Fungal Ball, a Tertiary Hospital Experience. Int J Otorhinolaryngol. 2020;6(1):16-18. doi: 10.11648/j.ijo.20200601.14

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  • @article{10.11648/j.ijo.20200601.14,
      author = {Ali Almomen and Hussain Albaharna and Abdullah Al Shakhs and Mohammed Alfalah and Mohammed Al Saeed and Zahra Alabbad and Zainab Aljaziri},
      title = {Sphenoid Sinus Fungal Ball, a Tertiary Hospital Experience},
      journal = {International Journal of Otorhinolaryngology},
      volume = {6},
      number = {1},
      pages = {16-18},
      doi = {10.11648/j.ijo.20200601.14},
      url = {https://doi.org/10.11648/j.ijo.20200601.14},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ijo.20200601.14},
      abstract = {Objective: To present the different clinical manifestations and diagnostic strategies of isolated sphenoid sinus fungal ball (SSFB), in order to prevent delayed diagnosis and providing early management. Method: This study is a retrospective clinical study, conducted between January 2008 and November 2019. It was done in the ENT department of two institutes: King Fahad specialist Hospital and Qatif Central Hospital, Saudi Arabia. Only patients with sole involvement of fungal ball in the sphenoid sinus were included. Conclusions: The incidence of isolated sphenoid fungal ball is rare. However, it's clinically important because untreated SSFB can cause significant complications. The clinical features of SSFB are ambiguous and nonspecific which make its diagnosis more difficult. Post-nasal discharge and headache refractory to the medical management are the most common symptoms of isolated sphenoid sinus lesion. CT scan is still the cornerstone of radiological diagnosis of SSFB. Endoscopic sphenoidotomy and removal of fungal debris is the standard care of management. Post-operatively, the majority of patient had good results with no complication and recurrence.},
     year = {2020}
    }
    

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    T1  - Sphenoid Sinus Fungal Ball, a Tertiary Hospital Experience
    AU  - Ali Almomen
    AU  - Hussain Albaharna
    AU  - Abdullah Al Shakhs
    AU  - Mohammed Alfalah
    AU  - Mohammed Al Saeed
    AU  - Zahra Alabbad
    AU  - Zainab Aljaziri
    Y1  - 2020/04/14
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ijo.20200601.14
    DO  - 10.11648/j.ijo.20200601.14
    T2  - International Journal of Otorhinolaryngology
    JF  - International Journal of Otorhinolaryngology
    JO  - International Journal of Otorhinolaryngology
    SP  - 16
    EP  - 18
    PB  - Science Publishing Group
    SN  - 2472-2413
    UR  - https://doi.org/10.11648/j.ijo.20200601.14
    AB  - Objective: To present the different clinical manifestations and diagnostic strategies of isolated sphenoid sinus fungal ball (SSFB), in order to prevent delayed diagnosis and providing early management. Method: This study is a retrospective clinical study, conducted between January 2008 and November 2019. It was done in the ENT department of two institutes: King Fahad specialist Hospital and Qatif Central Hospital, Saudi Arabia. Only patients with sole involvement of fungal ball in the sphenoid sinus were included. Conclusions: The incidence of isolated sphenoid fungal ball is rare. However, it's clinically important because untreated SSFB can cause significant complications. The clinical features of SSFB are ambiguous and nonspecific which make its diagnosis more difficult. Post-nasal discharge and headache refractory to the medical management are the most common symptoms of isolated sphenoid sinus lesion. CT scan is still the cornerstone of radiological diagnosis of SSFB. Endoscopic sphenoidotomy and removal of fungal debris is the standard care of management. Post-operatively, the majority of patient had good results with no complication and recurrence.
    VL  - 6
    IS  - 1
    ER  - 

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Author Information
  • Otolaryngology Department, King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia

  • Otolaryngology Department, Qatif Central Hospital, Qatif, Kingdom of Saudi Arabia

  • ENT Department, King Faisal University, Al-Hasa, Saudi Arabia

  • ENT Department, King Faisal University, Al-Hasa, Saudi Arabia

  • ENT Department, Al-Baha University, Al-Baha, Saudi Arabia

  • ENT Department, King Faisal University, Al-Hasa, Saudi Arabia

  • ENT Department, King Faisal University, Al-Hasa, Saudi Arabia

  • Section