Abstract
Aims: This article describes the report of a rare case of fungal ball in
the frontal sinus in an adult male and discuss about the variables of
this condition related to the patient. Additionally, this study aims to
identify the state of the art of fungal ball in paranasal sinuses,
especially in the frontal sinus. Method: We performed a literature
review on fungal ball in the paranasal sinuses and described a rare case
of fungal ball in the frontal sinus, which is listed as the paranasal
sinus most rarely affected by fungal ball. Result: All reported cases of
fungus ball in the frontal sinus affected male patients, contrary to the
common prevalence of females in fungal ball of the other paranasal
sinuses. Of the total of 8 patients with fungal ball in the frontal
sinus reported, 40% had unilateral disease and 60% bilateral, also
contrary to the incidence data of the other paranasal sinuses, with
unilateral prevalence. However, with the present study, this index
changes, with 50% unilateral and 50% bilateral in frontal sinus
involvement. The average age of cases reported in the frontal sinus is
65.29 years, with a minimum age of 61.16 and a maximum of 69 years. As
for the etiologic agent, Aspergillus sp., the endonasal endoscopic
therapeutic approach corresponded to 80% of cases, while frontal
osteoplasty accounted for 20% of cases, reaffirming this prevalence
data from other studies. Conclusion: Despite being a low incidence
entity, frontal sinus fungal ball should be considered in patients with
pain in the frontal region refractory to the usual clinical treatments.
We hope to contribute to the knowledge of this presentation as a
differential diagnosis and reinforce the importance of thorough clinical
investigation.