Clin Exp Otorhinolaryngol.  2016 Dec;9(4):326-331. 10.21053/ceo.2015.01571.

Clinical Characteristics of Sphenoid Sinus Fungal Ball Patients With Visual Disturbance

• Kim JS
• Kim BK
• Hong SD
• Kim HJ
• Kim HY

• KMID: 2360763
• DOI: http://doi.org/10.21053/ceo.2015.01571

Abstract

OBJECTIVES
A sphenoid sinus fungal ball is a rare disease that can cause visual disturbances. Most afflicted patients remain in an indolent state. However, once the visual disturbance has occurred, the recovery rate is very low. The purpose of this study was to overview the clinical characteristics of patients with a sphenoid sinus fungal ball and ascertain factors possibly related to the occurrence of a visual disturbance.
METHODS
We retrospectively reviewed the medical records of all patients who underwent endoscopic sinus surgery for a sphenoid sinus fungal ball at our hospital. We enrolled 47 patients in this study.
RESULTS
Old age and a female predominance were noted. Nasal symptoms were the most common symptom. Eight patients showed visual disturbances. We also compared the clinical characteristics between patients with and without visual disturbances in univariate analysis. Old age, underlying diabetes mellitus, and a sphenoid sinus wall defect visible by computed tomography were factors significantly related to the occurrence of visual disturbances. But only sphenoid sinus wall defect showed significance in multivariate analysis.
CONCLUSION
It is important to prevent complications, such as visual disturbance, in patients with a sphenoid sinus fungal ball. This study describes an early surgical treatment that may be required for patients with a sphenoid sinus fungal ball and particularly patients with a sphenoid sinus wall defect.

Keyword

Sphenoid Sinus; Aspergillosis; Vision Disorders

MeSH Terms

Aspergillosis
Diabetes Mellitus
Female
Humans
Medical Records
Multivariate Analysis
Rare Diseases
Retrospective Studies
Sphenoid Sinus*
Vision Disorders

Figure

• 

  Fig. 1. Computed tomography scans of different presentations of a sphenoid sinus fungal ball. Both images show total opacity of the sphenoid sinuses. (A) Sclerosis of the sphenoid sinus bony wall. (B) Sphenoid sinus bony wall defect (arrow).

• 

  Fig. 2. Magnetic resonance imaging (MRI) presentation of a sphenoid sinus fungal ball in patient with a visual disturbance. (A) T1-weighted coronal image showing intermediate signal intensity fi lling of the sphenoid cavity and enhanced lesions of the cavernous sinus (arrow). (B) T1-weighted axial image showing orbital apex (arrowhead) on an orbital MRI.

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