Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-23T12:59:07.336Z Has data issue: false hasContentIssue false
  • English
  • Français

Isolated sphenoid fungal sinusitis and vision loss: the case for early intervention

Published online by Cambridge University Press:  13 January 2009

L Hu ,
D Wang  and
H Yu
L Hu
Affiliation:
Department of Otolaryngology, Shanghai Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, PR China
D Wang*
Affiliation:
Department of Otolaryngology, Shanghai Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, PR China
H Yu
Affiliation:
Department of Otolaryngology, Shanghai Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, PR China
*
Address for correspondence: Dr Dehui Wang, Department of Otolaryngology, Shanghai Eye, Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyand Road, Shanghai 200031, PR China. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

We report two extremely rare cases of isolated sphenoid ‘fungal ball’ in conjunction with vision loss.

Method:

Case reports and a literature review concerning diagnosis and management of isolated sphenoid fungal ball in conjunction with vision loss.

Results:

A mycetoma or fungal ball resulting from isolated sphenoid fungal sinusitis is a rare disease. It is frequently difficult to diagnose, as patients present with nonspecific symptoms such as headache, visual disturbance and cranial nerve palsies. Diagnosis of the disease is typically not made until advanced imaging has been performed. We present two cases of patients with sphenoid sinus fungal ball who developed headaches and vision loss. One patient had symptoms of IIIrd cranial nerve palsy and the other partial visual field impairment. After a timely sphenoidotomy, both patients recovered fully, with resolution of all symptoms.

Conclusion:

These two cases of sphenoid fungal ball in conjunction with vision loss suggest that the otolaryngologist should keep this disease in mind even when symptoms are nonspecific. Endoscopic surgery can be a safe and viable therapeutic approach for this condition.

Keywords

SinusitisFungusVisionEndoscopy
Type
Online Only Clinical Records
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 2 , February 2009 , e8
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Lawson, W, Reino, AJ. Isolated sphenoid sinus disease: an analysis of 132 cases. Laryngoscope 1997;107:1590–5CrossRefGoogle ScholarPubMed
2Lee, LA, Huang, CC, Lee, TJ. Prolonged visual disturbance secondary to isolated sphenoid sinus disease. Laryngoscope 2004;114:986–90CrossRefGoogle ScholarPubMed
3Müller, T, Wolf, SR, Velten, I. Bilateral, progressive vision loss. Aspergilloma of the left sphenoid sinus with concomitant neuritis of both optic nerves [in German]. HNO 2001;49:406–7Google ScholarPubMed
4Hnatuk, LA, Macdonald, RE, Papsin, BC. Isolated sphenoid sinusitis: the Toronto Hospital for Sick Children experience and review of the literature. J Otolaryngol 1994;23:36–41Google ScholarPubMed
5Friedman, A, Batra, PS, Fakhri, S, Citardi, MJ, Lanza, DC. Isolated sphenoid sinus disease: etiology and management. Otolaryngol Head Neck Surg 2005;133:544–50CrossRefGoogle ScholarPubMed
6Grillone, GA, Kasznica, P. Isolated sphenoid sinus disease. Otolaryngol Clin North Am 2004;37:435–51CrossRefGoogle ScholarPubMed
7Dale, BA, Mackenzie, IJ. The complications of sphenoid sinusitis. J Laryngol Otol 1983;97:661–70CrossRefGoogle ScholarPubMed
8Unlu, HH, Aslan, A, Goktan, C, Egrilmez, M. The intracranial complication of acute isolated sphenoid sinusitis. Auris Nasus Larynx 2002;29:69–71CrossRefGoogle ScholarPubMed
9deShazo, RD, O'Brien, M, Chapin, K, Soto-Aquilar, M, Gardner, L, Swain, R. A new classification and diagnostic criteria for invasive fungal sinusitis. Arch Otolaryngol Head Neck Surg 1997;123:1181–8CrossRefGoogle ScholarPubMed
10Metson, R, Gliklich, RE. Endoscopic treatment of sphenoid sinusitis. Otolaryngol Head Neck Surg 1996;114:736–44Google ScholarPubMed
11Blitzer, A, Lawson, W. Fungal infections of the nose and paranasal sinuses. Part I. Otolaryngol Clin North Am 1993;26:1007–35CrossRefGoogle ScholarPubMed
12Lee, LA, Lee, TJ, Huang, CC. Endoscopic sinus surgery for solitary abducens palsy in patients with isolated sphenoid sinus disease: report of four cases. Chang Gung Med J 2002;25:689–94Google ScholarPubMed
13Deans, JA, Welch, AR. Acute isolated sphenoid sinusitis: a disease with complications. J Laryngol Otol 1991;105:1072–4CrossRefGoogle ScholarPubMed