Literature DB >> 27283592

Extrasinonasal infiltrative process associated with a sinonasal fungus ball: does it mean invasive fungal sinusitis?

Yi Kyung Kim1, Hyung Jin Kim, Hyo Yeol Kim, Jihoon Cha, Ji Young Lee, Seung Kyu Chung, Hun Jong Dhong, Mina Song, Sung Tae Kim.   

Abstract

PURPOSE: Invasive fungal sinusitis (IFS) has rarely been reported to develop from non-IFS. The purpose of this study was to disclose the nature of the extrasinonasal infiltrative process in the presence of a sinonasal fungus ball (FB).
METHODS: We retrospectively reviewed the medical records, computed tomography, magnetic resonance images of 13 patients with sinonasal FB and the extrasinonasal infiltrative process. Based on histology and clinical course, we divided the extrasinonasal infiltrative process into IFS and the nonfungal inflammatory/infectious process (NFIP). The images were analyzed with particular attention to the presence of cervicofacial tissue infarction (CFTI).
RESULTS: Of the 13 patients, IFS was confirmed in only one, while the remaining 12 were diagnosed to have presumed NFIP. One patient with IFS died shortly after diagnosis. In contrast, all 12 patients with presumed NFIP, except one, survived during a mean follow-up of 17 months. FB was located in the maxillary sinus (n=4), sphenoid sinus (n=8), and both sinuses (n=1). Bone defect was found in five patients, of whom four had a defect in the sphenoid sinus. Various sites were involved in the extrasinonasal infiltrative process, including the orbit (n=10), intracranial cavity (n=9), and soft tissues of the face and neck (n=7). CFTI was recognized only in one patient with IFS.
CONCLUSION: In most cases, the extrasinonasal infiltrative process in the presence of sinonasal FB did not seem to be caused by IFS but probably by NFIP. In our study, there were more cases of invasive changes with the sphenoid than with the maxillary FB.

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Year:  2016        PMID: 27283592      PMCID: PMC4956020          DOI: 10.5152/dir.2015.15417

Source DB:  PubMed          Journal:  Diagn Interv Radiol        ISSN: 1305-3825            Impact factor:   2.630


  30 in total

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Authors:  Jungmin Seo; Hyung-Jin Kim; Seung-Kyu Chung; Eunhee Kim; Hanbee Lee; Jin Wook Choi; Ji Hoon Cha; Hye Jung Kim; Sung Tae Kim
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  1 in total

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