title: Surgical and pathogenetic considerations of frontal sinus fungus ball.
abstract: Fungus ball (FB) is an non-invasive form of mycosis, that generally affects immunocompetent and non-atopic subjects. Involvement of the frontal sinus is extremely rare. We report two cases with frontal sinus fungus ball that underwent endoscopic endonasal frontal Draf type IIb or III sinusotomy with complete removal of the cheesy clay-like material. There were no intra-operative or postoperative complications, and no recurrence of disease was evident during the follow-up of 51 and 26 months, respectively. The Draf type IIb or type III frontal sinusotomy seems to be highly effective for the treatment of frontal sinus FB and can represent a valid alternative to the traditional external approaches.
authors.affiliation: Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria-Varese, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Via Guicciardini 9, 21100, Varese, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Bernardini
authors.affiliation: Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria-Varese, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Via Guicciardini 9, 21100, Varese, Italy. alkis.karligkiotis@gmail.com.|Head and Neck Surgery & Forensic Dissection Research Center (HNS&FDRC), Department of Biotechnology and Life Sciences, University of Insubria-Varese, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy. alkis.karligkiotis@gmail.com.
authors.forename: Apostolos
authors.identifier: http://orcid.org/0000-0003-0129-9908
authors.initials: A
authors.lastname: Karligkiotis
authors.affiliation: Department of Otorhinolaryngology, University of Pisa, Pisa, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Fortunato
authors.affiliation: Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria-Varese, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Via Guicciardini 9, 21100, Varese, Italy.|Head and Neck Surgery & Forensic Dissection Research Center (HNS&FDRC), Department of Biotechnology and Life Sciences, University of Insubria-Varese, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Castelnuovo
authors.affiliation: Head and Neck Surgery & Forensic Dissection Research Center (HNS&FDRC), Department of Biotechnology and Life Sciences, University of Insubria-Varese, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.|Department of Otorhinolaryngology, University of Pisa, Pisa, Italy.
authors.forename: Iacopo
authors.initials: I
authors.lastname: Dallan
mesh_terms: D000368:Aged; D001232:Aspergillus fumigatus / Q000302:isolation & purification*; D005626:Frontal Sinus / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery; D015522:Frontal Sinusitis / Q000175:diagnosis / Q000382:microbiology / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007558:Italy; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D059747:Nasal Surgical Procedures / Q000379:methods*; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
keywords: Aspergillosis; Aspergillus; Draf procedures; Endoscopic modified Lothrop procedure; Endoscopic sinus surgery; Mycetoma; Mycosis; Paranasal sinuses