Paranasal sinus fungus ball and surgery: a review of 175 cases
Volume: 43 - Issue: 1
First page: 34 - Last page: 39
X. Dufour - C. Kauffmann-Lacroix - J.C. Ferrie - J.M. Goujon - M.H. Rodier - A. Karkas - J.M. Klossek
Objective: To analyze the surgical results after Functional Endoscopic Sinus Surgery (FESS)
in patients with paranasal sinus fungus ball.
Material and methods: Retrospective analysis of the results of FESS performed in 175
patients suffering from paranasal sinus fungus balls.
Results: All maxillary (n=150), sphenoidal (n= 20), and ethmoidal (n = 4) locations have
been treated exclusively by FESS to obtain a wide opening of the affected sinuses, allowing a
careful extraction of all fungal material without removal of the inflamed mucous membrane.
No major complication occurred. Postoperative care was reduced to nasal lavage with topical
steroids for 3 to 6 weeks. Only 1 case of local failure have been observed (maxillary sinus,
n = 1), and 6 cases of persisting of fungus ball (maxillary sinus, n = 4; frontal sinus, n = 2)
with a mean follow-up of 5 years. No medical treatment (antibiotic, antifungal) was
required.
Conclusion: Surgical treatment of a fungus ball consists in opening the infected sinus cavity
at the level of its ostium and removing fungal concretions while sparing the normal mucosa.
No antifungal therapy is required. Finally, through this 175 patients study, FESS appears a
reliable and safe surgical treatment with a low morbidity.
Rhinology 43-1: 34-39, 2005
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