Vol.101 No.1 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 101 No. 1 January 2008
Clinical Consideration of Fungal Paranasal Sinusitis
Tsuyoshi Okuni
(Muroran City Hospital, Sapporo Medical University)
Koji Asakura and Tomo Homma
(Muroran City Hospital)
Ryuichi Kawaguchi
(Takikawa ENT Clinic)
Tadataka Ishikawa
(Ishikawa ENT Clinic)
Norikazu Yamazaki
(Hakodate Goryokaku Hospital)
Tetsuo Himi
(Sapporo Medical University)
Fungal paranasal sinusitis is included in the differential diagnosis of unilateral paranasl lesion. Recently the incidence of fungal paranasal sinusitis has been increasing. We reviewed 24 patients (9 males and 15 females) with fungal paranasal sinusitis treated at Muroran City Hospital between January 2001 and May 2006, and clinical presentation and CT findings with those of 56 patients (36 males and 20 females) with chronic unilateral sinusitis. Fungal sinusitis patients ranged in age from 45 to 87, and the average age was 65.9 years old. In contrast, the age of chronic sinusitis patients ranged from 24 to 83, and the average age was 54.4 years old. The chief complaint of both fungal sinusitis and chronic sinusitis included rhinorrhea, nasal obstruction and post nasal discharge.
CT exam was performed in all patients. In 23 cases of paranasal fungal sinusitis and 54 cases of chronic sinusitis the findings involved the maxillary sinus. The most common observation (69.6％) was bone density within the affected sinus in fungal sinusitis. However, only 2 cases of chronic sinusitis (3.9％) showed calcification.
All cases of fungal sinusitis were diagnosed by pathological examinations. Most cases were proved to be aspergillus, while only one case was mucor. We treated all cases surgically, 18 cases underwent Caldwell-Luc's procedure and 5 cases underwent endoscopic sinus surgery under local anesthesia.
Key words :fungal sinusitis, unilateral paranasal lesion, chronic sinusitis