Abstract：
OBJECTIVE: The aim was to assess the developmental attributes of sphenoid sinuses affected by fungal balls and describe a surgical approach which reestablishes gravity-dependent drainage to compensate for any mucociliary dysfunction.
METHODS: A within-patient case-control analysis was performed on sphenoid sinus dimensions from patients with sphenoid sinus fungal ball (SSFB). Radiological dimensions were assessed to determine the dominant or larger sinus by volume and width. Pneumatization in the sagittal and lateral extent was assessed. The influence of sinus size and pneumatization variants within a patient was analyzed. Patency and the presence of mucostasis from radical reshaping of the sinus cavity were documented at least 3 months after surgery. Complications (bleeding, cerebrospinal fluid leak, and cranial nerve palsy) were recorded.
RESULTS: Twenty-three patients (59 ± 19 years, 86% female, 46 sphenoid sinuses) were assessed. Fungal ball was more common in the smaller (non-dominant) sinus, by width (78% vs. 22%, p < 0.01) and by proportion of total sphenoid volume (0.39 ± 0.16 vs. 0.61 ± 0.16, p < 0.01). Pneumatization variants did not influence the development of SSFB within a patient. All patients had patency and the absence of mucostasis or persistent inflammation at last follow-up. No complications were reported.
CONCLUSIONS: The smaller or nondominant sphenoid sinus is more affected by SSFB. Surgical reshaping of the sphenoid to prevent mucostasis is favorable in managing the smaller affected sinus cavity.
METHODS: 4 Laryngoscope, 2024.
METHODS: A within-patient case-control analysis was performed on sphenoid sinus dimensions from patients with sphenoid sinus fungal ball (SSFB). Radiological dimensions were assessed to determine the dominant or larger sinus by volume and width. Pneumatization in the sagittal and lateral extent was assessed. The influence of sinus size and pneumatization variants within a patient was analyzed. Patency and the presence of mucostasis from radical reshaping of the sinus cavity were documented at least 3 months after surgery. Complications (bleeding, cerebrospinal fluid leak, and cranial nerve palsy) were recorded.
RESULTS: Twenty-three patients (59 ± 19 years, 86% female, 46 sphenoid sinuses) were assessed. Fungal ball was more common in the smaller (non-dominant) sinus, by width (78% vs. 22%, p < 0.01) and by proportion of total sphenoid volume (0.39 ± 0.16 vs. 0.61 ± 0.16, p < 0.01). Pneumatization variants did not influence the development of SSFB within a patient. All patients had patency and the absence of mucostasis or persistent inflammation at last follow-up. No complications were reported.
CONCLUSIONS: The smaller or nondominant sphenoid sinus is more affected by SSFB. Surgical reshaping of the sphenoid to prevent mucostasis is favorable in managing the smaller affected sinus cavity.
METHODS: 4 Laryngoscope, 2024.
摘要：
目的：目的是评估受真菌球影响的蝶窦的发育特征，并描述一种重建重力依赖性引流以补偿任何粘液纤毛功能障碍的手术方法。
方法：对蝶窦真菌球（SSFB）患者的蝶窦尺寸进行了患者内部病例对照分析。评估放射学尺寸以通过体积和宽度确定优势或更大的窦。评估矢状和侧向范围的气动。分析了患者鼻窦大小和气化变异的影响。手术后至少3个月，记录了窦腔根治性重塑的通畅性和粘液的存在。并发症（出血，脑脊液漏,和颅神经麻痹）记录。
结果：23例患者（59±19岁，86%女性,评估了46个蝶窦）。真菌球在较小（非优势）的窦中更常见，按宽度(78%与22%,p<0.01）和蝶骨总体积的比例（0.39±0.16vs.0.61±0.16，p<0.01)。气动变体不会影响患者体内SSFB的发展。在最后一次随访时，所有患者均通畅，无粘液淤滞或持续炎症。无并发症报告。
结论：较小的或非优势的蝶窦受SSFB的影响更大。手术重塑蝶骨以防止粘液停滞有利于管理较小的受影响的窦腔。
方法：4喉镜，2024.
方法：对蝶窦真菌球（SSFB）患者的蝶窦尺寸进行了患者内部病例对照分析。评估放射学尺寸以通过体积和宽度确定优势或更大的窦。评估矢状和侧向范围的气动。分析了患者鼻窦大小和气化变异的影响。手术后至少3个月，记录了窦腔根治性重塑的通畅性和粘液的存在。并发症（出血，脑脊液漏,和颅神经麻痹）记录。
结果：23例患者（59±19岁，86%女性,评估了46个蝶窦）。真菌球在较小（非优势）的窦中更常见，按宽度(78%与22%,p<0.01）和蝶骨总体积的比例（0.39±0.16vs.0.61±0.16，p<0.01)。气动变体不会影响患者体内SSFB的发展。在最后一次随访时，所有患者均通畅，无粘液淤滞或持续炎症。无并发症报告。
结论：较小的或非优势的蝶窦受SSFB的影响更大。手术重塑蝶骨以防止粘液停滞有利于管理较小的受影响的窦腔。
方法：4喉镜，2024.
