Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2021, Vol. 35 ›› Issue (5): 32-35.doi: 10.6040/j.issn.1673-3770.0.2021.041

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Computed tomography-based preoperative diagnosis of fungal ball sinusitis

QIN He1, WAN Baogang2, WANG Hongli1, ZHAO Benqi3   

  1. 1. Department of Otorhinolaryngology & Head and Neck Surgery, Beijing Tsinghua Changgung Hospital/School of Clinical Medical, Tsinghua University, Beijing 102218, China;
    2. Health Care Department of the Outpatient Department, The Air Force Command of the Chinese People's Liberation Army, Beijing 100843, China;
    3. Department of Radiology, Beijing Tsinghua Changgung Hospital/School of Clinical Medical, Tsinghua University, Beijing 102218, China
  • Published:2021-09-29

Abstract: Objective To investigate the computed tomography(CT)features of fungal ball sinusitis and evaluate their preoperative usefulness in differential diagnosis. Methods The CT scans of 32 patients preoperatively diagnosed with fungal ball sinusitis between January 2019 and December 2020 were retrospectively analyzed. The perioperative findings were compared with the preoperative CT findings. Histopathology and fungal smears were performed postoperatively. Results Of the 32 patients, 30 were diagnosed with fungal ball sinusitis based on the perioperative findings and postoperative histopathology; the diagnostic accuracy was 93.7%. In these 30 patients, the CT characteristics included intralesional hyperdensity, calcification spots, irregular surfaces, and sclerosis of the lateral sinus wall. Among the two other patients, one was diagnosed with eosinophilic papilloma of the maxillary sinus and the other was pathologically diagnosed with hemorrhagic necrotizing polyps. Conclusion Intralesional hyperdensity with calcification spots is a specific CT feature of fungal ball sinusitis. Partial opacification with an irregular surface and bony sclerosis in the areas affected by sinusitis are also CT characteristics. There is a risk of misdiagnosis when diagnosis is based solely on CT examinations.

Key words: Fungi ball, Nasal sinusitis, Tomography, X-ray computed, Endoscopic sinus surgery

CLC Number: 

  • R765.4
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