Fungus ball in concha bullosa, an unusual site: a case report from hilly region
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20175648Keywords:
Fungal ball, Concha bullosa, Rhinosinusitis, Endoscopic sinus surgeryAbstract
Fungus is a rare cause of rhinosinusitis in children. Its incidence has been reported as ranging between 13.5 and 28%. Fungus balls are extramucosal tangled masses of fungal hyphae. It commonly involves just one paranasal sinus. Most commonly maxillary sinus is involved and occasionally sphenoid sinus. Concha bullosa is one of the most common anatomical variations in the nasal cavity, with a frequency of reporting ranging from 14-53.6%. There are very few case reports in which Concha bullosa was affected with fungus ball. In this case report 13 years female child presented with complaints of swelling right cheek. The patient underwent endoscopic sinus surgery and there was involvement of concha bullosa and sphenoid sinus with fungus ball. Fungus was confirmed on microscopic examination and culture. Fungus ball is a rare presentation of fungal rhinosinusitis. It should be considered in enlarged middle turbinate with heterogenous opacity on CT. The diagnosis should be confirmed by microscopy or culture.
References
Grigoriu D, Bambule J, Delacretaz J, Savary M. Fungal maxillary sinusitis. Dermatologica. 1979;159:180-6.
Chakrabarti A, Sharma SC. Paranasal sinus mycoses. Indian J Chest Dis Allied Sci. 2000;42:293-304.
Zinreich S, Albayram S, Benson M, Oliverio P. The osteomeatal complex and functional endoscopic surgery. Head and neck imaging, Som P, editor. 4th edition. St. Louis, Mo, USA: Mosby; 2003: 149-173.
Bradoo, R. Anatomical Principles of Endoscopic Sinus Surgery A Step by Step Approach. NewDelhi: Jaypee; 2012: 93-94.
Cukurova I, Demirhan E, Karaman Y, Yigitbasi OG. Extraordinary Pathologic Entities within the Concha Bullosa. Saudi Med J. 2009;30:937-41.
Montone KT, Livolsi VA, Feldman MD, Palmer J, Chiu AG, Lanza DC, et al. Fungal Rhinosinusitis: A Retrospective Microbiologic and Pathologic Review of 400 Patients at a Single University Medical Center. Int J Otolaryngol. 2012;684835:1-9.
Agarwal S. Paranasal Sinuses Fungal Balls in Children. Clin Rhinol: An Int J. 2010;3(3):181-3.
Gleeson M, Browning G, Vurton MJ, Clarke R, Hibbert J, Jones NS, et al. Scott-Brown’s Otorhinolaryngology, Head and Neck Surgery, 7th ed. Ann R Coll Surg Engl. 2011;93(7):559.
Alper NE, Alper K. Our approach to cases with fungus balls of the paranasal sinuses. J Med Updates. 2014;4(1):25-8.
Grosjean P, Weber R. Fungus balls of paranasal sinuses: a review. Eur Arch Otorhinolaryngol. 2007;264(5):461-70.
