The Association of Nasal Septal Deviation with Solitary Sphenoidal Fungus Ball: Retrospective Analysis of 43 Patients

Abstract

Objective: A Solitary Sphenoid Fungus Ball (SSFB) is an uncommon unilateral collection of non-invasive fungal hyphae in the sphenoid sinus. The association and potential impact of nasal septal deviation (NSD) on the pathogenesis of SSFB has not been fully assessed. The purposes of this study were to investigate whether NSD is associated with SSFB, and to assess the alterations to adjacent structures caused by SSFB. Methods: Forty-three patients with SSFB were enrolled as the study group. Another 43 age and sex matched patients that underwent trans-sphenoidal resection of a pituitary tumor were enrolled as the control group. The incidence of NSD, and alterations to adjacent bony structures were compared between these two groups. Analysis of the relationship between the direction and severity of NSD with the ipsilateral occurrence of fungus ball in the sphenoid sinus was also performed. Results: The incidence of NSD in patients with SSFB (86.05%) was statistically higher than that in control group (39.53%) (p<0.001). Neither the direction of NSD (p=0.861) nor the severity of NSD (p=0.442) would impact the ipsilateral occurrence of the SSFB. An expanded sphenoid ostia, punctate calcifications, and bony wall sclerosis were the main characteristics on CT imaging. Central signal deficiency was a typical characteristic on T2WI MRI. Conclusion: NSD was common in patients with SSFB. However, no statistically significant difference was detected between the direction and severity of NSDon the ipsilateral occurrence of the sphenoidalfungal sinusitis.