Sphenoid sinus fungal balls.
OBJECTIVE
We sought to examine the nature of fungal balls of the sphenoid sinus, in particular the exposure of adjacent skull base structures and the potential for surgical morbidity.


METHODS
We retrospectively reviewed our series of 17 cases of sphenoid sinus fungal balls seen between 1998 and 2005 with reference to their diagnosis, radiologic changes, histopathology, and surgical management.


RESULTS
Exposed structures included the pituitary fossa, cavernous sinus, and cavernous internal carotid artery, but this exposure did not result in an increase in perioperative complications. Sclerotic thickening of the sinus walls persisted, probably representing a chronic osteitis in response to concurrent bacterial infection. This appeared to be protective against further sinus wall erosions. Wall erosions did not heal. One patient demonstrated what appeared to be invasive fungal disease from a fungal ball.


CONCLUSIONS
Sphenoid sinus fungal balls can occur with minimal symptoms in a mainly elderly population and require surgical removal. Sphenoid sinus fungal balls have a low rate of operative morbidity and should be effectively managed by transnasal endoscopic sphenoidotomy alone.
Bowman
James
J
Department of Otorhinolaryngology-Head and Neck Surgery, Greenslopes Private Hospital, Greenslopes, Australia.
Panizza
Benedict
B
Gandhi
Mitesh
M
D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000150:complications; D004724:Endoscopy; D005260:Female; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000150:complications / Q000175:diagnosis*; D012189:Retrospective Studies; D013101:Sphenoid Sinus / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D015524:Sphenoid Sinusitis / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery*; D014057:Tomography, X-Ray Computed