Section: 
Science articles
Science articlesThe present-day aspects of diagnostics of fungal balls of paranasal sinuses
V. V. Dvoryanchikov (1), V. G. Mironov (1), A. V. Chernysh (1), L. A. Glaznikov (1), F. A. Syroezhkin (1), A. N. Sergeev (1), S. S. Pavlova (2), S. A. Bannikov (3)
(1) Kirov Military Medical Academy of the Ministry of Defense of Russia, Saint-Petersburg, 194044, Russia
(2) Saint Petersburg Research Institute of Ear, Throat, Nose and Speech Ministry of Healthcare of Russia, Saint Petersburg, 190013, Russia
(3) Regional Consultative and Diagnostic Center, Rostov-on-Don, 344020, Russia
UDK: 616.216.1-002.828-07
DOI: https://doi.org/10.18692/1810-4800-2019-3-33-38
ABSTRACT
Objective. The Improvement of diagnostics and treatment of noninvasive paranasal sinus mycoses (fungal balls). Materials and methods of study. The authors have examined 49 patients in which an endoscopic incision of paranasal sinuses had revealed the unstructured caseous lumps suggesting the existence of a fungal ball. The isolated defect of maxillary sinus was revealed in 29 patients, a sphenoid sinus defect – in 19 patients, an ethmoidal sinus defect – in 1 patient. The age of the patients was from 25 to 67 years. Results. The direct (primary) microscopy was more sensitive and informative method of a fungal infection identification (73.8% of cases of detection of fungi) than cultural mycological examination that revealed the fungal growth only in 30.9% of cases of histopathologically confirmed fungal balls. The authors have obtained microbiological and histological confirmation of fungal process in 60% of caseous sinusitis cases; they emphasize that it is clinically impossible to diagnose a fungal sinusitis. Conclusion. The clinical manifestations of fungal ball of the paranasal sinuses are non-specific; presurgical diagnostic is generally based on the data of X-ray examination methods. In the event of revealing the unstructured caseous lumps upon incision of paranasal sinuses it is necessary to differentiate fungal and bacterial alternative processes (osteomyelitis, chronic sinusitis) caused by anaerobic flora. The histopathological examination of the sinus content is the most informative method of fungal balls diagnostics.
Publication date:
18.06.2019
Keywords:
noninvasive mycoses, paranasal sinuses, sinusitis, fungal bodies, diagnostic. For citation:
Dvoryanchikov V. V., Mironov V. G., Chernysh A. V., Glaznikov L. A., Syroezhkin F. A., Sergeev A. N., Pavlova S. S., Bannikov S. A. The present-day aspects of diagnostics of fungal balls of paranasal sinuses. Rossiiskaya otorinolaringologiya. 2019;18(3):33–38. https://doi.org/ 10.18692/1810-4800-2019-3-33-38.