title: Surgical treatment of Aspergillus mycetomas of the maxillary sinus: review of the literature.
abstract: The present study reviews the literature concerning the surgical treatment of Aspergillus mycetoma (AM) in the last 20 years to identify a gold standard surgical technique. Aspergillus mycetoma of the maxillary sinus, or mycetoma (fungus ball), is a noninvasive or extramucosal mycotic infection. Surgical removal of the sinus fungal masses to ensure drainage and aeration is performed using the traditional Caldwell-Luc (CL) procedure or endoscopic sinus surgery (ESS). Results of this review suggest that the gold standard surgical technique for AM is ESS with middle meatal antrostomy. General or local antifungal drugs are not indicated. Combined approach with an intraoral surgical access from the anterolateral wall of the maxillary sinus has to be reserved for selected cases in which ESS doesn't permit complete extraction of all fungal concretions or foreign bodies. The CL procedure should be avoided, because it has detrimental consequences for sinus physiology.
authors: Department of Maxillofacial Surgery, Azienda Ospedaliero Universitaria, Faculty of Medicine, University of Udine, Udine, Italy. maxil2@med.uniud.it
authors: Fabio
authors: F
authors: Costa
authors: Francesco
authors: F
authors: Polini
authors: Nicoletta
authors: N
authors: Zerman
authors: Massimo
authors: M
authors: Robiony
authors: Corrado
authors: C
authors: Toro
authors: Massimo
authors: M
authors: Politi
mesh_terms: D001228:Aspergillosis / Q000382:microbiology / Q000601:surgery*; D004724:Endoscopy; D006801:Humans; D008443:Maxillary Sinus / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010254:Paranasal Sinus Diseases / Q000382:microbiology / Q000601:surgery*