Department of Otorhinolaryngology Head and Neck Surgery, 71185Peking University People's Hospital, Beijing, People's Republic of China.
Ear Nose Throat J. 2022 Dec;101(10):NP459-NP467. doi: 10.1177/0145561320982188. Epub 2020 Dec 18.
The most common type of noninvasive fungal rhinosinusitis is fungus ball (FB), which usually involves a solitary paranasal sinus. Multiple fungus balls (MFBs) are rarely reported in literature. The purpose of this study was to analyze and compare the clinical features of MFBs and solitary fungus ball (SFB).
We retrospectively investigated consecutive cases of FB between 2001 and 2018 and compared the clinical records of SFB with MFBs with respect to demographics, clinical features, location, radiological findings, and operative outcome.
A total of 440 SFB and 43 MFBs cases were included in the study. The mean age was 55.3 ± 13.3 and 60.6 ± 10.9 years, respectively ( = .011). The incidence of MFBs obviously increased from 2001 to 2018. The clinical symptoms and laboratory examination were similar. On computed tomography images, complete opacification, septal deviation, Haller cells, and obstruction of ostiomeatal complex were more common ( < .05). The incidence of SFB on the left and right sides was similar, while MFBs were seen to involve both sides in 74.4%.
Compared with SFB, MFBs showed some special characteristics. The MFBs affected older patients showed wide range of lesions and complex anatomy. Surgical technique is very important. Much more attention should be paid to this not so uncommon disease during the perioperative period.
最常见的非侵袭性真菌性鼻旁窦炎是真菌球（FB），通常涉及单个鼻旁窦。多发性真菌球（MFB）在文献中很少报道。本研究旨在分析和比较 MFB 和孤立性真菌球（SFB）的临床特征。
我们回顾性调查了 2001 年至 2018 年期间的 FB 连续病例，并比较了 SFB 和 MFB 的临床记录，包括人口统计学、临床特征、位置、影像学发现和手术结果。
本研究共纳入 440 例 SFB 和 43 例 MFB 病例。平均年龄分别为 55.3±13.3 岁和 60.6±10.9 岁（=0.011）。MFB 的发病率从 2001 年到 2018 年明显增加。临床症状和实验室检查相似。在计算机断层扫描图像上，完全闭塞、鼻中隔偏曲、Haller 细胞和窦口复合体阻塞更为常见（<0.05）。SFB 左侧和右侧的发生率相似，而 MFB 则有 74.4%累及双侧。
与 SFB 相比，MFB 表现出一些特殊特征。MFB 影响的老年患者病变范围广泛，解剖结构复杂。手术技术非常重要。在围手术期应更加关注这种并不罕见的疾病。
