Analysis of factors affecting diagnosis of unilateral isolated fungal sphenoid sinusitis.

Background: To analyze the characteristics and factors influencing the diagnosis of unilateral isolated fungal sphenoid sinusitis.

Methods: A retrospective analysis was conducted on the clinical data of patients who underwent surgery for unilateral isolated sphenoid sinusitis between June 2020 and May 2023. Data collected included variables such as gender, age, side of the specimen, symptoms, sinus computed tomography findings, pathological results, and complications. The patients were categorized into two groups: the sphenoid sinusitis group and the fungal sphenoid sinusitis group.

Results: Among the 84 cases studied, there were 19 males (22.6%) and 65 females (77.4%). Inflammation was observed in 11 patients (13.1%), while fungi were detected in 73 patients (86.9%). Headache was reported in 74 cases (88.1%). Sinus computed tomography findings revealed calcified plaques/spots in 51 cases (60.7%), hyperosteogeny in 75 cases (89.3%), and bone destruction in 11 cases (13.1%). The thickness of the sinus wall ranged from 0.92 to 7.35 mm. The thickness ratio of the bilateral sinus walls ranged from 0.80 to 6.78. The chi-square test indicated significant differences between the two groups in terms of calcified plaques/spots, hyperosteogeny, the thickness of the lesion-side sinus wall, and the ratio of bilateral sinus walls (p < 0.05). Diagnostic tests using the ROC curve demonstrated that calcified plaques/spots, the thickness of the lesion-side sinus wall, and the ratio of bilateral sinus walls had moderate accuracy in diagnosing fungal sphenoid sinusitis.

Conclusion: While headache is not a specific symptom of fungal sphenoid sinusitis, sinus computed tomography findings such as calcified plaque/spots, the thickness of the lesion-side sinus wall, and the thickness ratio of bilateral sinus walls are valuable for diagnosis.