Literature review
The state of the art on fungal ball in paranasal sinuses shows the prevalence of fungal ball in paranasal sinuses in the age group of 50 to 60 years. Prospective studies reaffirm the prevalence of fungal ball in the maxillary sinus, followed by the sphenoid, ethmoid and, finally, the frontal sinus, recommended by retrospective studies, as well as the higher incidence being unilateral and in the female sex, with the most prevalent etiological agent being Aspergillus spp. The therapeutic approach of choice, unanimously, is the endonasal endoscopy in any affected paranasal sinuses.
The reported cases of fungal ball in the frontal sinus affected male patients, contrary to the common prevalence of female sex in a fungal ball of the other paranasal sinuses. Applying statistical data, it appears that of the 8 patients with reported fungal ball in the frontal sinus, 40% had unilateral affection 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.
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. The average age of reported cases is 65.29 years, with a minimum age of 61.16 and a maximum of 69 years. The summary of data referring to reports of fungal ball in the frontal sinus are listed in Table 1.