[MYCETOMA].

Abstract

Introduction: Sinonasal mycetoma (fungus ball) is a non-invasive, typically unilateral fungal infection affecting one of the paranasal sinuses. It presents with variable clinical symptoms such as facial pain and unilateral nasal discharge or may be discovered incidentally on imaging. Fungus ball, or Mycetoma, is a saprophytic infection of the paranasal sinuses. Usually, it is an isolated disease of one paranasal sinus, most commonly the maxillary sinus. The sinus obstruction and accumulation of fungi, typically Aspergillus Fumigatus causes a chronic infection which can be asymptomatic or associated with headache/ facial pain, unilateral rhinorrhea, and nasal obstruction. Ocular symptoms can also occur. Clinical diagnosis is confirmed by imaging, mostly computed tomography (CT). CT will show sinus opacification with or without associated calcifications and hyperostosis. Treatment is surgical, with Functional Endoscopic Sinus Surgery as the gold standard. The typical finding is a mucopurulent cheesy material within the sinus. The surgery consists of complete fungal debridement and lavage while creating the optimal ventilation of the sinus involved. A definite diagnosis can be made with histopathological and microbiologic testing of samples. Antibiotic therapy before or after surgery is not required, according to the literature.