Abstract

Fungal rhinosinusitis (FRS) is categorized as being either invasive or non-invasive based on the histopathological evidence of tissue invasion by fungi. Endoscopic sinus surgery (ESS) has become the gold standard treatment for non-invasive FRS including sinus fungal ball. It is considered to be an effective and safe procedure. It is important to keep a sufficient field of view in order to remove the fungal debris completely. ESS should also prevent damage to the nasal cavity structures including the inferior turbinate. This report mainly describes the endoscopic surgical procedures for fungal ball of the maxillary sinus (sinus mycelia) based on our methods and review of the literature, including written articles in Japanese. ESS procedures include the middle meatus approach for the maxillary sinus, the combined approach (both middle and inferior meatal antrostomy) for the maxillary sinus, and endoscopic modified medial maxillectomy (EMMM).

Highlights

  • Fungal rhinosinusitis (FRS) is categorized as being either invasive or non-invasive based on the histopathological evidence of tissue invasion by fungi

  • This report mainly describes about endonasal endoscopic surgical procedures for fungal maxillary sinusitis, based on our methods and a review of the literature, which included Japanese articles (Table 1)

  • Our study showed that the results of Endoscopic sinus surgery (ESS) with the combined approach were better than the middle meatal approach alone without inferior meatal antrostomy [6]

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Summary

Introduction

Fungal rhinosinusitis (FRS) is categorized as either invasive or non-invasive based on the histopathological evidence of tissue invasion by fungi [1]. Fungal ball is the most frequent cause of non-invasive FRS, and the maxillary sinus is the most common location [1] [4]. Endoscopic sinus surgery (ESS) has become the gold standard of treatment or chronic rhinosinusitis, including non-invasive fungal sinusitis. It is considered as an effectiveness and safe procedure, and the recurrence rate is about 5% (0% 22.5%) [4]. This report mainly describes about endonasal endoscopic surgical procedures for fungal maxillary sinusitis (fungal ball, sinus mycelia), based on our methods and a review of the literature, which included Japanese articles (Table 1)

ESS for Fungal Maxillary Sinusitis
Middle Meatus Approach
Using Powered Devices
Complications
Post-Operative Care
Findings
Conclusion
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