Fungus Ball in an Agger Nasi Cell

A 51-year-old woman was referred to the Department of Otolaryngology at Wonkwang University School of Medicine with right-sided headaches and postnasal drip. Although her physician at the local clinic had been prescribing medications for the previous 3 months, her condition had not improved. She denied having a history oflong-term steroid use or any underlying systemic diseases. Nasal endoscopy revealed an edematous uncinate process in the patient's right nasal cavity, and the right side of her middle meatus was almost completely obstructed. Coronal computed tomography (CT) scans also revealed opacities in the right agger nasi cell (ANC) (figure, A) and the maxillary sinus (figure, B). Endoscopic sinus surgery was performed under general anesthesia. After the uncinate process was removed, dark yellowish material was found near the right maxillary sinus ostium; the material was removed with a forceps. Through a middle meatal antrostomy, a small amount of pus was observed in the right maxillary sinus. Next, the right ANC was opened and another piece of dark yellowish material was discovered there (figure, C). The material was removed via curved suction (figure, D), and pathologic analysis Continuedon page476