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.
Highlights
Histopathological, fungal rhinosinusitis can be divided into invasive and noninvasive infection
The main focus of this study is to present the different clinical manifestations and diagnostic strategies of sphenoid sinus fungal ball (SSFB), in order to prevent delayed diagnosis and providing early management
We have reported some pre-operative complications of the SSFB itself but we didn’t report any major complication post operatively
Summary
Histopathological, fungal rhinosinusitis can be divided into invasive and noninvasive infection. In rare cases isolated sphenoid has been reported, which represent only 2.7% of all sinus diseases [3, 4]. Even though isolated sphenoid sinus lesion is rare, it's very significant clinically due to its undetectable anatomical location, ambiguous symptoms and the complications associated with injury to the above structures [5]. The main focus of this study is to present the different clinical manifestations and diagnostic strategies of sphenoid sinus fungal ball (SSFB), in order to prevent delayed diagnosis and providing early management. It was conducted at King Fahad Specialist Hospital (KFSHD), and Qatif Central Hospital, Eastern region, Saudi Arabia
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