Bola fúngica sinusal: análisis de nuestra casuística / Fungus ball of the paranasal sinuses: Analysis of our serie of patients

Introducción y objetivos: La bola fúngica es la forma más frecuente de rinosinusitis fúngica. El objetivo de nuestro estudio es analizar las características clínicas y los resultados de la cirugía en nuestra serie de pacientes. Métodos: Se analizaron retrospectivamente 35 pacientes con bola fúngica tratados en nuestro centro entre 2006 y 2014. Resultados: La edad media fue de 55 años. El 49% de los pacientes fueron varones y el 51% mujeres. El 75% se localizaron en el seno maxilar y el 25% restante en el seno esfenoidal. La clínica más frecuente fue obstrucción nasal, rinorrea y algias craneofaciales. El 69% de pacientes mostró microcalcificaciones intrasinusales en la tomografía computerizada. Todos los pacientes fueron intervenidos quirúrgicamente, sin registrarse recidivas. Conclusiones: Las manifestaciones clínicas de la bola fúngica son muy inespecíficas, por lo que el diagnóstico de sospecha se hace mediante endoscopia y estudio de imagen. El estudio histopatológico confirma el diagnóstico. La cirugía endoscópica nasosinusal es la base del tratamiento de la bola fúngica, limitándose a la apertura del seno (o senos) afecto, y exéresis completa de la lesión. La tasa de complicaciones postoperatorias es muy baja, y no es necesario tratamiento antifúngico oral o tópico concomitante (AU)

Introduction and objectives: The fungus ball is the most frequent type of fungal rhino-sinusitis. The objective of this study is to analyze the clinical and surgical features of our patients. Methods: Retrospective analysis of 35 patients with fungus ball treated in our centre between 2006 and 2014. Results: Mean age was 55 years old. 49% were men and 51% women. 75% involved the maxillary sinus, whereas 25% involved the sphenoid. 69% of our patients showed microcalcifications in the CT study. All the patients were surgically treated, with no cases of recurrence. Conclusions: Clinical manifestations of fungus ball are non-specific, therefore endoscopy and image study are mandatory. The definitive diagnosis is made by histopathological study of the lesion. Endoscopic sinus surgery is the treatment of choice, with opening of the diseased sinus and complete removal of the fungus ball. The frequency of complications is very low. No oral or topical antimycotic treatments are necessary (AU)

Fungus ball of the paranasal sinuses: Analysis of our serie of patients. / Bola fúngica sinusal: análisis de nuestra casuística.

INTRODUCTION AND OBJECTIVES: The fungus ball is the most frequent type of fungal rhino-sinusitis. The objective of this study is to analyze the clinical and surgical features of our patients. METHODS: Retrospective analysis of 35 patients with fungus ball treated in our centre between 2006 and 2014. RESULTS: Mean age was 55 years old. 49% were men and 51% women. 75% involved the maxillary sinus, whereas 25% involved the sphenoid. 69% of our patients showed microcalcifications in the CT study. All the patients were surgically treated, with no cases of recurrence. CONCLUSIONS: Clinical manifestations of fungus ball are non-specific, therefore endoscopy and image study are mandatory. The definitive diagnosis is made by histopathological study of the lesion. Endoscopic sinus surgery is the treatment of choice, with opening of the diseased sinus and complete removal of the fungus ball. The frequency of complications is very low. No oral or topical antimycotic treatments are necessary.

Análisis clínico y resultados quirúrgicos en 58 mucoceles nasosinusales / Clinical analysis and surgical results of 58 paranasal sinus mucoceles

Introducción: Los mucoceles son lesiones benignas que afectan a los senos paranasales, de crecimiento lento, con capacidad de reabsorción ósea. Exponemos nuestra experiencia en el tratamiento quirúrgico de estas lesiones. Métodos: Se realizó un estudio retrospectivo de 58 mucoceles nasosinusales diagnósticados en 54 pacientes entre los años 1989-2012. Se analizaron las diferentes localizaciones, distribución por edad y sexo, características clínicas, tipo de abordaje quirúrgico, recidivas y complicaciones. Resultados: La edad media de los pacientes en el momento del diagnóstico fue de 59 años. El 57% de los pacientes (31/54) fueron varones y el 43% (23/54) mujeres. En el 55% de los casos (32/58) el mucocele estaba localizado en el seno frontal o en la región frontoetmoidal, un 14% (8/58) en el seno etmoidal, un 24% (14/58) en el seno maxilar y un 7% (4/58) en seno esfenoidal. En el 55% de los casos se identificó algún factor predisponente, siendo el 45% mucoceles primarios. El 71% de los pacientes fueron tratados con un abordaje endonasal endoscópico y en el 29% se realizó un abordaje abierto o combinado. Observamos un total de 4 recidivas (7%), 2 en el grupo abordaje endonasal endoscópico y 2 en el grupo tratado con cirugía abierta. Conclusiones: El tratamiento de elección de los mucoceles nasosinusales es la arsupialización por vía endonasal endoscópica, siendo una técnica segura y con buenos resultados (AU)

Introduction: Mucoceles are slow-growing, benign lesions found in the paranasal sinuses that are locally destructive, causing bony resorption an displacement of adjacent structures. We present our experience in the surgical treatment of these lesions. Methods: This was a retrospective review of 58 paranasal sinus mucoceles in 54 patients between 1989 and 2012. We describe patient age and sex, mucocele location, clinical features, surgical approaches employed, recurrence and complications. Results: The mean age of patients in this series was 59 years; there were 31 males (57%) and 23 females (43%). Thirty-two cases (55%) were located in the frontal or ethmoid-frontal system, 8 (14%) in the ethmoid sinus, 14 (24%) in the maxillary sinus and 4 (7%) in sphenoid sinus. Predisposing factors were present in 55% of the patients and 45% cases were primary. Endoscopic treatment was given to 71% of mucocele patients, while 29% were treated with external or combined approaches. Recurrence appeared in 4 patients (7%), 2 in the endoscopic surgery group and 2 in the external surgery group. Conclusions: The procedure of choice for management of paranasal sinus mucoceles is endoscopic drainage. It is a safe approach that gives good results (AU)

[Clinical analysis and surgical results of 58 paranasal sinus mucoceles]. / Análisis clínico y resultados quirúrgicos en 58 mucoceles nasosinusales.

INTRODUCTION: Mucoceles are slow-growing, benign lesions found in the paranasal sinuses that are locally destructive, causing bony resorption an displacement of adjacent structures. We present our experience in the surgical treatment of these lesions. METHODS: This was a retrospective review of 58 paranasal sinus mucoceles in 54 patients between 1989 and 2012. We describe patient age and sex, mucocele location, clinical features, surgical approaches employed, recurrence and complications. RESULTS: The mean age of patients in this series was 59 years; there were 31 males (57%) and 23 females (43%). Thirty-two cases (55%) were located in the frontal or ethmoid-frontal system, 8 (14%) in the ethmoid sinus, 14 (24%) in the maxillary sinus and 4 (7%) in sphenoid sinus. Predisposing factors were present in 55% of the patients and 45% cases were primary. Endoscopic treatment was given to 71% of mucocele patients, while 29% were treated with external or combined approaches. Recurrence appeared in 4 patients (7%), 2 in the endoscopic surgery group and 2 in the external surgery group. CONCLUSIONS: The procedure of choice for management of paranasal sinus mucoceles is endoscopic drainage. It is a safe approach that gives good results.

Sarcoidosis y parálisis de cuerdas vocales: a propósito de 2 casos y revisión de la literatura / Sarcoidosis and true vocal fold paresis: 2 cases and a review of the literature

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