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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2022; 26(04): e738-e743
DOI: 10.1055/s-0041-1740598
Systematic Review

Rare Presentations of Frontal Sinus Fungus Ball: A Systematic Review

Bárbara Okabaiasse Luizeti 
1   Department of Medicine, Faculdade de Medicina, Universidade Cesumar, Maringá, Paraná, Brazil
,
Lesley Ane Roks de Lima 
1   Department of Medicine, Faculdade de Medicina, Universidade Cesumar, Maringá, Paraná, Brazil
,
Jonas Willian Spies 
2   Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto, Universidade de of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil
3   Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial (ABORL-CCF), São Paulo, São Paulo, Brazil
,
Guilherme Constante Preis Sella 
1   Department of Medicine, Faculdade de Medicina, Universidade Cesumar, Maringá, Paraná, Brazil
2   Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto, Universidade de of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil
3   Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial (ABORL-CCF), São Paulo, São Paulo, Brazil
4   Academia Brasileira de Cirurgia Plástica da Face (ABCPF), São Paulo, São Paulo, Brazil
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Abstract

Introduction The sinus fungus ball is an agglomeration of debris and hyphae, mainly caused by Aspergillus fumigatus, within the paranasal sinus, commonly affecting a single sinus, and it only rarely affects the frontal sinus.

Objective To identify the state of the art of fungus ball in paranasal sinuses, especially related to the epidemiology of the disease in the frontal sinus. Additionally, this article reports a rare case of fungus ball in the frontal sinus in an adult male, and discusses the variables of this condition related to the patient.

Data Synthesis All of the 8 cases of fungus ball in the frontal sinus reported in this study affected male patients: 40% had unilateral disease, and 60%, bilateral disease, contrary to the incidence data of fungus ball in the other paranasal sinuses, which reports unilateral prevalence. However, in the present study, this index changes, with 50% of unilateral and 50% of bilateral incidence regarding frontal sinus involvement. The average age of the patients was 65.36 years (range: 60-74 years). The etiologic agent was Aspergillus spp., and the endonasal endoscopic therapeutic approach corresponded to 80% of cases, while frontal osteoplasty accounted for 20% of cases, reaffirming the prevalence data from other studies.

Conclusion Despite being a low-incidence entity, frontal sinus fungus ball should be considered in patients with pain in the frontal region refractory to the usual clinical treatments.

Keywords

aspergillus fumigatus - communicable diseases - complications - transanal endoscopic surgery - paranasal sinus diseases


Publication History

Received: 11 February 2021

Accepted: 23 September 2021

Article published online:
27 January 2022

© 2022. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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