A retrospective analysis of 29 isolated sphenoid fungus ball cases from a medical centre in Korea (1999-2012).
BACKGROUND
Isolated sphenoid sinus disease (ISSD) is rare. Fungus ball (FB) is the third most common ISSD. We analysed the characteristics of isolated sphenoid FB based on demographic data, presenting symptoms, preoperative computed tomography (CT), magnetic resonance imaging (MRI), and treatment outcomes.


METHODS
From 1999 to 2012, 29 patients were identified with isolated sphenoid FB. Demographic data; clinical characteristics; endoscopic, CT, and MRI findings and treatment outcomes were retrospectively analysed.


RESULTS
The most common symptom was headaches, which were localized in various regions of the brain. Other symptoms were uncommon. The most common CT findings were sclerosis, calcification, enlarged sinus and total opacification. On T2-weighted MRI images, we most commonly observed signal void. Endoscopic transnasal paraseptal sphenoidotomy was performed in all patients, and for most, this was performed under local anaesthesia. No recurrence was observed in any patient.


CONCLUSIONS
Isolated sphenoid FB is predominantly observed in older women, and it is characterised by headaches and sclerosis of the sinus wall observed on CT scans. In cases of isolated sphenoid FB, endoscopic transnasal paraseptal sphenoidotomy can be successfully performed under local anaesthesia, which may facilitate rapid recovery and a low morbidity rate.
Department of Otorhinolaryngology, Daegu Fatima Hospital, Daegu, South Korea.
T H
TH
Kim
K J
KJ
Na
J H
JH
Seok
S J
SJ
Heo
J H
JH
Park
J S
JS
Kim
D000328:Adult; D000368:Aged; D004724:Endoscopy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery*; D012189:Retrospective Studies; D013101:Sphenoid Sinus / Q000382:microbiology*; D015524:Sphenoid Sinusitis / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome