Infected Concha Bullosa with Fungus

Document Type : Case Report

Authors

Department of Otorhinolaryngology - Head and Neck Surgery, Bakırköy Dr.Sadi Konuk Training and Research Hospital, Istanbul, Turkey.

Abstract

Introduction:
Concha bullosa is the most common variation of the middle turbinate of the paranasal sinuses. When it causes nasal obstruction, osteomeatal unit dysfunction, or rarely chronic infection, surgery is required.
 
Case Report:
We present a fungal infection of concha bullosa, which is a rare indication for surgery of the concha bullosa. A 59-year-old female patient presented with hemifacial pain on the right side, which had lasted for 2 months. There were no pathological findings in her endoscopic nasal examination. Advanced examination by paranasal computed tomography (CT) revealed bilateral concha bullosa variation and soft tissue density in the right concha bullosa. As the biopsy taken from concha bullosa demonstrated fungal hyphae, endoscopic surgical treatment was performed.
 
Conclusion:
We stress the importance of the CT in hemifacial pain by this rare case report, in which endoscopic nasal examination was normal. Fungal infection in the concha bullosa is rare, and infected concha bullosa is a pathology to be considered in the differential diagnosis in patients with complaints of hemicranial headache.

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References

1. Çınar U, Yiğit Ö, Uslu B, Alkan S. Pyocele of the middle turbinate: a case report. Kulak Burun Bogaz Ihtis Derg 2004;12:35–8.
2. Robey AB, O’Brien EK, Richardson BE, Baker JJ, Poage DP, Leopold DA. The changing face of paranasal sinus fungus balls. Ann Otol Rhinol Laryngol. 2009;118:500–5.
3. Bradoo R. Anatomical Principles of Endoscopic Sinus Surgery A Step by Step Approach. Jaypee, New Delhi 2012;93–4.
4. Cukurova I, Demirhan E, Karaman Y, Yigitbasi OG. Extraordinary Pathologic Entities within the Concha Bullosa. Saudi Medical J, 2009;30:937-41.
5. Dufour X, Lacroix KC, Ferrie JC, Goujon JM, Rodier MH, Klossek JM. Paranasal Sinus Fungus Ball: Epidemiology, Clinical Features and Diagnosis. A Retrospective Analysis of 173 Cases. Medical Mycology 2006;44:61–7.
6. Kurtzman CP, Smiley MJ, Robnett CJ, Wicklow DT. DNA relatedness among wild and domesticated species of the Aspergillus flavus. Mycologica 1986;78(6):955–9.
7. Kurosawa M, Kobayashi S, Yanagihara Y, Shida T. A case of occupational allergic broncho- pulmonary aspergillosis unique to Japan. Br J Clin Pract 1990; 44:482–9.
8. Akiyama K, Takizawa H, Suzuki M, Miyachi S, Ichinohe M, Yanagihara Y. Allergic bronchopulmonary aspergillosis due to Aspergillus oryzae. Chest 1987;91:285–6.
9. Byard RW, Bonin RA, Haq AU. Invasion of paranasal sinuses by Aspergillus oryzae. Mycopathologia 1986;96:41–3.
10. Kim KS, Kim HJ. Periorbital pain induced by the concha bullosa fungus ball: a case report. J Oral Facial Pain Headache. 2014;28:277–9.
11. Toplu Y, Toplu SA, Can S, Kuzucu C. Fungus ball in concha bullosa: an unusual cause of retro-orbital pain. J Craniofac Surg. 2014;25:e138–40.
12. Cukurova I, Gümüşsoy M, Mercan Caner RG, Yaz A, Avcı A. Fungus ball in middle  concha bullosa: a case report. Kulak Burun Bogaz Ihtis Derg. 2011; 21:110–4.
Iranian Journal of Otorhinolaryngology
Volume 31, Issue 2
March and April 2019
Pages 131-133

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