Clin Exp Otorhinolaryngol.  2012 Dec;5(4):213-217. 10.3342/ceo.2012.5.4.213.

What is the Relationship between the Localization of Maxillary Fungal Balls and Intranasal Anatomic Variations?

  • 1Department of Otolaryngology-Head and Neck Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea.


Although the mechanisms underlying the initiation and maintenance of inflammation in unilateral maxillary fungal balls (FBs) are poorly understood, the relationship between intranasal anatomy and maxillary FB is thought to play an important role. The aim of this study was to investigate the relationship between anatomic variations and FB.
We enrolled 140 patients who were composed of 56 patients with FB, 56 patients with unilateral chronic rhinosinusitis (CRS), and 28 patients with no sinus disease. Computed tomography scans were retrospectively analyzed to identify and compare the associated nasal anatomic abnormalities. To measure the volume of the nasal cavity and middle meatus, computed tomography scans were reconstructed into three-dimensional images.
The relatively larger volume of the middle meatus was associated with the localization of the FB in contrast with the CRS. However, the nasal-cavity volume, nasal valve area, and nasal septal deviation were not significantly associated with localization of FB. The mean volumetric and areal measurements such as nasal cavity, middle meatus, and nasal valve in FB-ipsilateral sides were not significantly different from those in contralateral sides as well as other groups.
The middle meatus bears the major part of the inspiratory nasal airflow, and its volume may influence the occurrence of FB.


Computed tomography; Fungus ball; Paranasal sinuses; Middle meatus; Nasal septum; Volume

MeSH Terms

Nasal Cavity
Nasal Septum
Paranasal Sinuses
Retrospective Studies


  • Fig. 1 The schematized volumes of the nasal cavity and middle meatus in the lateral nasal wall of the right nasal cavity (A) and coronal CT scan (B). Vol NC, volume of the nasal cavity; Vol MM, volume of the middle meatus; asterisk, middle turbinate.

  • Fig. 2 Three-dimensional reconstruction and measurement of the volume of the nasal cavity (A) and the middle meatus (B) after segmentations according to anatomic boundaries on the coronal, axial, and sagittal views.

  • Fig. 3 The reformatted cross-sectional images orthogonal to the imaginary air pathway (A) and sagittal image illustrated by the yellow-colored plane perpendicular to the acoustic axis for measuring the nasal valve area (B).

  • Fig. 4 Right-sided deviation of the nasal septum at the nasal valve level (A) and the ostiomeatal unit level (B). Point c, crista galli; point d, anterior nasal spine.

Cited by  1 articles

Do Anatomical Variations Affect the Location of Solitary Sphenoid Sinus Fungal Balls? A 10-Year Retrospective Study
Jeon Gang Doo, Hye Kyu Min, Jin-Young Min
J Rhinol. 2024;31(1):22-28.    doi: 10.18787/jr.2024.00001.


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