Xu Yang1, Ke Lei. 1. Department of Otorhinolaryngology, Shanghai Xuhui Central Hospital, Shanghai, 200031, China. lileyyang@126.com
Abstract
OBJECTIVE: To improve the cognition of fungal ball sinusitis (FB) for diagnosing and treatting it rightly, we retrospectively analyzed the hospitalization cases. METHOD: We analyzed 98 cases FB patients' first symptom, acoustic rhinometry, CT manifestation, operation fashion. RESULT: The first symptoms of FB include: 47.2% nosebleed, 38.8% snuffle, 28.6% headache and face-ache, 4.0% nasal peculiar smell, 2.0% excessive tear, 4.0% no symptom. Anterior nasoscope inspection include: 43.9% no significant abnormity, 13.3% nasoseptal deviation. 41.8% nasal cavity neoplasm (nasal polyp, nasoturbinal polyp, nasal meatus fugal ball etc), 25.5% secretion in nasal cavity. The parameters that conclude the nasal airway resistance (NAR), nasal cavity volume (NCV) and nasal minimal cross-section area (NMCA) have extremely difference (P<0.01) between FB and normal volunteers (NV): the NAR increase, but NCV and NMCA decrease; the Distance of the Minimal cross-sectional area from the nostril (DCAN) appear moving backword compared with NV. The CT manifestation: almost unilateral lesions, involved paranasal sinuses present asymmetric or symmetrical opacification: 60.2% with calcified area, 25.5% with local bone erosion, 74.5% with sinus wall sclerosis. 65.3% of the CT diagnoses as FB are accord with pathology diagnoses. The incidence of FB involve maxillary sinus most (54.1%), then sphenoid sinus (11.2%) and ethmoid sinus (5.1%), frontal sinus (2.0%), multi-sinus (32.7%). All cases operated functional endoscopy surgery: 13 cases with nasoseptal diorthosis, 4 cases with inferior meatus opening, 2 case with canine fossa opening; we clean up the fungal pathogen with different degree endoscope through different path. CONCLUSION: The clinical symptom of FB is not representative; the acoustic rhinometry show that NAR increasing but NCV and NMCA decreasing maybe the reason of fungal infection; the CT examine is helpful for FB diagnosis; the functional endoscopy surgery is efficient therapy for FB.
OBJECTIVE: To improve the cognition of fungal ball sinusitis (FB) for diagnosing and treatting it rightly, we retrospectively analyzed the hospitalization cases. METHOD: We analyzed 98 cases FB patients' first symptom, acoustic rhinometry, CT manifestation, operation fashion. RESULT: The first symptoms of FB include: 47.2% nosebleed, 38.8% snuffle, 28.6% headache and face-ache, 4.0% nasal peculiar smell, 2.0% excessive tear, 4.0% no symptom. Anterior nasoscope inspection include: 43.9% no significant abnormity, 13.3% nasoseptal deviation. 41.8% nasal cavity neoplasm (nasal polyp, nasoturbinal polyp, nasal meatus fugal ball etc), 25.5% secretion in nasal cavity. The parameters that conclude the nasal airway resistance (NAR), nasal cavity volume (NCV) and nasal minimal cross-section area (NMCA) have extremely difference (P<0.01) between FB and normal volunteers (NV): the NAR increase, but NCV and NMCA decrease; the Distance of the Minimal cross-sectional area from the nostril (DCAN) appear moving backword compared with NV. The CT manifestation: almost unilateral lesions, involved paranasal sinuses present asymmetric or symmetrical opacification: 60.2% with calcified area, 25.5% with local bone erosion, 74.5% with sinus wall sclerosis. 65.3% of the CT diagnoses as FB are accord with pathology diagnoses. The incidence of FB involve maxillary sinus most (54.1%), then sphenoid sinus (11.2%) and ethmoid sinus (5.1%), frontal sinus (2.0%), multi-sinus (32.7%). All cases operated functional endoscopy surgery: 13 cases with nasoseptal diorthosis, 4 cases with inferior meatus opening, 2 case with canine fossa opening; we clean up the fungal pathogen with different degree endoscope through different path. CONCLUSION: The clinical symptom of FB is not representative; the acoustic rhinometry show that NAR increasing but NCV and NMCA decreasing maybe the reason of fungal infection; the CT examine is helpful for FB diagnosis; the functional endoscopy surgery is efficient therapy for FB.