J Rhinol.  2022 Mar;29(1):32-37. 10.18787/jr.2021.00392.

Clinical Characteristics According to the Radiological Classifications of Maxillary Sinus Fungus Ball

• Kim DH
• Kown JH
• Koo HB
• Lee JH

• KMID: 2528317
• DOI: http://doi.org/10.18787/jr.2021.00392

Abstract

Background and Objectives
The purpose of this study was to classify radiological findings of patients diagnosed with maxillary sinus fungus ball and to analyze the differences in surgical approach methods and postoperative results.
Methods
As a retrospective study, we reviewed the medical records of 221 patients (unilateral in 216: bilateral in 5).
Results
On computed tomography (CT), 49% of the lesions had an irregular surface or a protruding part. There was a significant difference in surgical approach according to pneumatization of the maxillary sinus when middle meatal antrostomy (MMA) was performed alone or combined with MMA and inferior meatal antrostomy (IMA) (p=0.042). Extension of a maxillary sinus lesion caused by fungus ball was not associated with stenosis of the MMA (p=0.328).
Conclusion
Diagnosis of maxillary sinus fungus on CT was associated with irregular lesion surface or a protruding calcification. In patients with fungus ball of the maxillary sinus, the more severe is the maxillary sinus pneumatization, the larger is the extent of IMA needed.

Keyword

Maxillary sinus; Fungus ball; Radiology; Inferior meatus; Antrostomy

Figure

• 

  Fig. 1. Computed tomographic findings of maxillary sinus fungus ball. Grade I shows a haziness less than 50% of the whole maxillary sinus with the irregular mucosal surface or a protruding lesion (A). Grade II shows a haziness more than 50% of the whole maxillary sinus and it is not the whole haziness, the mucosal part has the irregular surface or a protruding lesion (B). Grade III shows total haziness of maxillary sinus without mass effect (C). Grade IV shows total haziness of maxillary sinus with mass effect (D).

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  Fig. 2. Computed tomographic findings of maxillary sinus pneumatization. Grade I shows maxillary sinus pneumatization limited above the nasal floor level (A). Grade II shows maxillary sinus pneumatization limited to the nasal floor level (B). Grade III shows maxillary sinus pneumatization extended below the nasal floor level (C).

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  Fig. 3. Postoperative findings of well-opened (A) and stenotic (B) middle meatal antrostomy site (arrow: stenotic middle meatal antrostomy site).

Reference

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