Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University, School of Medicine, Daejeon, Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Yanbian University Hospital, Yanbian, China.
Int Forum Allergy Rhinol. 2017 Nov;7(11):1070-1075. doi: 10.1002/alr.22007. Epub 2017 Aug 26.
Sinonasal fungus ball (FB) is a type of noninvasive fungal rhinosinusitis affecting immunocompetent hosts. FB, previously considered rare, has been reported with increasing frequency. We reviewed our experience of 538 cases over the past 20 years.
We retrospectively examined clinical records including clinical presentations, radiological findings, management, and outcomes of FB patients who have undergone surgery for treatment. The number of FB patients who underwent endoscopic sinus surgery (ESS) was calculated annually. Causal relationships between structural variations and FB were also investigated.
The number of FB patients who underwent sinus surgery has increased. The mean age was 58.3 years, and the gender ratio was approximately 2 (female): 1 (male). While the most common presenting symptoms of maxillary sinus FB patients were nasal symptoms, such as postnasal drip and nasal obstruction, sphenoid sinus FB patients presented with headache mostly. On computed tomography (CT) scans, the most common finding was intralesional hyperdensity (77.3%). There was no significant correlation between the presence of FB and structural variations (nasal septal deviation, concha bullosa, Haller cell). Median follow-up period of the patients was 11 months. Recurrence or residual disease occurred in only 6 (1.1%) cases.
The number of FB patients who underwent surgery has increased steadily over the past 20 years. FB should be considered in patients with unilateral nasal symptoms and unexplained headaches. A preoperative CT scan is an essential tool in making diagnosis easier and faster. Endoscopic surgery is the treatment of choice, with a low morbidity and recurrence rate.
鼻窦真菌球（FB）是一种影响免疫功能正常宿主的非侵袭性真菌性鼻-鼻窦炎。FB 以前被认为很少见，但现在报道的频率越来越高。我们回顾了过去 20 年中 538 例患者的经验。
我们回顾性地检查了临床记录，包括接受手术治疗的 FB 患者的临床表现、影像学表现、治疗方法和结果。计算了每年接受内镜鼻窦手术（ESS）的 FB 患者人数。还研究了结构变化与 FB 之间的因果关系。
接受鼻窦手术的 FB 患者人数有所增加。平均年龄为 58.3 岁，男女比例约为 2（女）：1（男）。上颌窦 FB 患者最常见的首发症状是鼻部症状，如后鼻滴注和鼻塞，而蝶窦 FB 患者主要表现为头痛。在计算机断层扫描（CT）上，最常见的发现是病变内高密度（77.3%）。FB 的存在与结构变化（鼻中隔偏曲、鼻甲肥大、Haller 细胞）之间无显著相关性。患者的中位随访时间为 11 个月。仅 6 例（1.1%）复发或残留疾病。
过去 20 年来，接受手术治疗的 FB 患者数量稳步增加。对于单侧鼻部症状和不明原因头痛的患者，应考虑 FB。术前 CT 扫描是一种必不可少的工具，可以更轻松、更快地做出诊断。内镜手术是首选的治疗方法，具有较低的发病率和复发率。
