Fungal Ball in Sinus: Multi-Center Study in Daegu

ABSTRACT

BACKGROUND AND OBJECTIVES: Fungal sinusitis has been reported increasingly in immunocompetent patients and the fungus ball is the most frequent and best recognized form of fungal sinusitis. Fungus ball is usually unresponsive to appropriate medical treatment and surgery is the treatment of choice. The aim of this study is to evaluate the incidence, clinical symptoms and signs, and CT findings, the proportion of the patients with fungus ball. MATERIALS AND METHODS: In retrospective study, we reviewed medical records and CT findings of 255 patients with fungus ball confirmed by histopathologically among 6,217 patients who had undergone endoscopic sinus surgery between 1995 and 2004 at five medical centers in Daegu. RESULTS: The symptoms of fungus ball were nasal obstruction (64.4%), rhinorrhea (56.7%), PND (49.2%), cheek pain (26.4%) and foul odor (25.1%). Fungus ball was mostly encountered in only one maxillary sinus (76.4%) of an otherwise healthy person and preoperative computerized tomography (CT) revealed mottled calcific densities within the involved sinus in 55.2% of cases. The success rate of fungus ball surgery by endoscopy was 98.4%. CONCLUSION: This is the retrospective study to evaluate the prevalence of fungus ball (nearly 5%) among the endoscopic sinus surgery. To make a diagnosis of fungus ball, a high index of suspicion to unilateral symptomatic chronic sinusitis, often painful, unresponsive to appropriate medical treatment is necessary and endoscopic sinus surgery is and should remain the mainstay of treatment.