Sphenoid Sinus Fungal Ball and Reestablishing Sinus Function.

fungal ball mycetoma rhinosinusitis sphenoid sinus surgery

Journal

The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378

Informations de publication

Date de publication:
12 Jul 2024
Historique:
revised: 02 06 2024
received: 02 05 2024
accepted: 27 06 2024
medline: 12 7 2024
pubmed: 12 7 2024
entrez: 12 7 2024
Statut: aheadofprint

Résumé

The aim was to assess the developmental attributes of sphenoid sinuses affected by fungal balls and describe a surgical approach which reestablishes gravity-dependent drainage to compensate for any mucociliary dysfunction. A within-patient case-control analysis was performed on sphenoid sinus dimensions from patients with sphenoid sinus fungal ball (SSFB). Radiological dimensions were assessed to determine the dominant or larger sinus by volume and width. Pneumatization in the sagittal and lateral extent was assessed. The influence of sinus size and pneumatization variants within a patient was analyzed. Patency and the presence of mucostasis from radical reshaping of the sinus cavity were documented at least 3 months after surgery. Complications (bleeding, cerebrospinal fluid leak, and cranial nerve palsy) were recorded. Twenty-three patients (59 ± 19 years, 86% female, 46 sphenoid sinuses) were assessed. Fungal ball was more common in the smaller (non-dominant) sinus, by width (78% vs. 22%, p < 0.01) and by proportion of total sphenoid volume (0.39 ± 0.16 vs. 0.61 ± 0.16, p < 0.01). Pneumatization variants did not influence the development of SSFB within a patient. All patients had patency and the absence of mucostasis or persistent inflammation at last follow-up. No complications were reported. The smaller or nondominant sphenoid sinus is more affected by SSFB. Surgical reshaping of the sphenoid to prevent mucostasis is favorable in managing the smaller affected sinus cavity. 4 Laryngoscope, 2024.

Identifiants

DOI: 10.1002/lary.31635 PMID: 38994871
pubmed: 38994871
doi: 10.1002/lary.31635
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 The American Laryngological, Rhinological and Otological Society, Inc.

Références

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Auteurs

Christian M Meerwein (CM)

Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia.
Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
Department of Otorhinolaryngology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
ORCID: 0000-0002-8674-1007

Kachorn Seresirikachorn (K)

Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia.
Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
ORCID: 0000-0002-0158-7638

Blake Lindsay (B)

Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia.
Department of Otolaryngology, Head and Neck Surgery, Concord General Hospital, University of Sydney, Sydney, Australia.

Peta-Lee Sacks (PL)

Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia.
Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.

Larry Kalish (L)

Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia.
Department of Otolaryngology, Head and Neck Surgery, Concord General Hospital, University of Sydney, Sydney, Australia.
Faculty of Medicine, University of Sydney, Sydney, Australia.

Raewyn G Campbell (RG)

Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia.
Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
Department of Otolaryngology, Head and Neck Surgery, Royal Prince Alfred Hospital, Sydney, Australia.

Ray R Sacks (RR)

Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia.
Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
Department of Otolaryngology, Head and Neck Surgery, Concord General Hospital, University of Sydney, Sydney, Australia.

Richard J Harvey (RJ)

Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia.
Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.

Classifications MeSH