Department of Otorhinolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China.
Department of Radiology, Shandong Provincial ENT Hospital, Shandong University, Jinan, China.
Laryngoscope. 2023 Dec;133(12):3292-3298. doi: 10.1002/lary.30683. Epub 2023 Apr 6.
This study aimed to investigate the clinical characteristics of sphenoid sinus fungus ball (SSFB) to help increase the accuracy of diagnosis and efficiency of treatment.
We retrospectively analyzed the data of 77 patients who were histopathologically diagnosed with SSFB.
The mean age of SSFB patients was 52.4 years (range 25-84), and 47 patients (61.0%) were female. Compared to age-matched and sex-matched chronic rhinosinusitis (CRS) patients, headache was more common in SSFB patients (79.2%; p < 0.0001). SSFB patients also had higher prevalence of diabetes than CRS (p = 0.0420). The features of computed tomography (CT) were sphenoid sinus opacification (100%), sclerosis (93.5%), calcification (76.6%), and bone erosion (41.6%). Functional endoscopic sinus surgery (FESS) was the best treatment option, and the trans-ethmoid (n = 64, 83.1%) was the most commonly used approach. No one experienced a recurrence of SSFB in 44 successfully contacted patients. Six months after FESS, 91.0% of patients (40/44) established proper drainage in the sphenoid sinus. The recovery rates for headache and nasal symptoms were 91.7% (33/36) and 77.8% (7/9) respectively.
SSFB is more prevalent in older women and usually presents as unilateral headache. Diabetes is a potential risk factor for SSFB. CT findings provide evidence for diagnosis and suggestions for surgical approaches. FESS is the optimal treatment for SSFB. After FESS, most patients had good prognosis with no recurrence of SSFB. However, regular endoscopic follow-up is required due to the possibility of the postoperative closure of sphenoid ostium.
3 Laryngoscope, 133:3292-3298, 2023.
本研究旨在探讨蝶窦真菌球（SSFB）的临床特征，以提高诊断准确性和治疗效率。
我们回顾性分析了 77 例经组织病理学诊断为 SSFB 的患者数据。
SSFB 患者的平均年龄为 52.4 岁（25-84 岁），47 例（61.0%）为女性。与年龄和性别匹配的慢性鼻-鼻窦炎（CRS）患者相比，SSFB 患者头痛更为常见（79.2%；p<0.0001）。SSFB 患者的糖尿病患病率也高于 CRS（p=0.0420）。计算机断层扫描（CT）的特征为蝶窦混浊（100%）、硬化（93.5%）、钙化（76.6%）和骨质侵蚀（41.6%）。功能性内镜鼻窦手术（FESS）是最佳治疗选择，经筛窦入路（n=64，83.1%）最常用。在 44 例成功联系的患者中，无人出现 SSFB 复发。FESS 后 6 个月，44 例患者中 91.0%（40/44）蝶窦建立了适当的引流。头痛和鼻部症状的恢复率分别为 91.7%（33/36）和 77.8%（7/9）。
SSFB 多见于老年女性，通常表现为单侧头痛。糖尿病是 SSFB 的潜在危险因素。CT 表现为诊断提供依据，并提示手术入路。FESS 是 SSFB 的最佳治疗方法。FESS 后，大多数患者无 SSFB 复发，预后良好。但由于术后蝶窦口可能关闭，需要定期进行内镜随访。
3 级喉镜，133：3292-3298，2023。
