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.