درمان آندوسكوپيك آسپرزيلوماي سينوس اسفنوييد

ENDOSCOPIC TREATMENT OF SPHENOID ASPERGILLOMA

Fungal infection of the nose and Para nasal sinuses is an uncommon condition which is now being increasingly recognized in both normal and immunocompromised individuals who usually have a predisposing factor. Aspergillus is the most common reported cause of Fungal sinusitis followed by mucormycosis, Candida, Penicillium and Fusarium. The maxillary sinus is involved in most of the cases followed in order of frequency by the ethmoid and frontal sinuses. Lesions limited to sphenoid sinus are relatively rare with only 71 cases reported in the literature. We describe a 72 y/o patient who had a mocucele like lesion of the sphenoid sinus on her preoperative CT scan. The sphenoid was opened through Tran nasal endoscopic approach, and multiple clay - like tenacious material was removed under direct endoscopic vision. Histopathology examination revealed areas of necrosis, chronic inflammation and septated hypheas. Types and classifications of fungal infections, differential diagnosis of isolated sphenoid sinus disease, and the role of radiology in preoperative evaluation of the patients are also discussed.