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DESTRUCTIVE NON-INVASIVE INFECTION IN ISOLATED FRONTAL SINUS ASPERGILLOMA: REVEALING PREVALENCE AND PROPOSITION OF A NEW PATHOGENETIC MODEL.
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  • Isabelle Dohin,
  • Alessandro Vinciguerra,
  • Professor Anshul Sama,
  • Benjamin Verillaud,
  • philippe herman
Isabelle Dohin
Universita degli Studi di Brescia Dipartimento Specialita Medico-Chirurgiche Scienze Radiologiche e Sanita Pubblica

Corresponding Author:[email protected]

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Alessandro Vinciguerra
AP-HP
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Professor Anshul Sama
Nottingham University Hospitals NHS Trust
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Benjamin Verillaud
AP-HP
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philippe herman
AP-HP
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Abstract

Objectives: The aim of this study is to report our cases of isolated frontal sinus aspergilloma (FSA), and identify key features and aspects suggestive of this pathology. Moreover, we have investigated the pathogenesis of this FSA, which has not been clearly elucidated yet. Materials and Methods: A retrospective study on cases of isolated FSA treated at the unit of Otolaryngology of the Hopital Lariboisière in Paris from 2009 to 2023 was performed. A chart review was done, Demographic and radiologic data, type of treatment with intraoperative findings, and follow-up were analyzed. Moreover, a literature review was carried out on Pubmed and Scopus using the search terms “frontal sinus aspergilloma”, “frontal sinus fungus ball” and “frontal sinus mycetoma”. Non-invasive FSA characteristics, especially the relation with surrounding bony structures were analyzed. Results: Six patients were included. The median age of the patients was 58 years old (range 25-69); 2/6 patients were female. The most common symptom was headache. All the patients underwent exclusive endoscopic sinus surgery. With regards to literature review, 17 papers have been identified reporting a total number of 30 cases of FSA. Overall, frontal sinus walls erosion was described in 47% of the cases showing a prevalence of erosive behavior of this pathology. Conclusions: FSA shows a higher incidence of bone erosion compared to other PSA. The destructive behavior of FSA could increase the risk of potential intracranial and intraorbital complications. Recognizing the radiological features of FSA, is crucial for accurate differential diagnosis with invasive forms of fungal infections and treatment planning.
17 Feb 2024Submitted to Clinical Otolaryngology
20 Feb 2024Assigned to Editor
20 Feb 2024Submission Checks Completed
24 Feb 2024Reviewer(s) Assigned
16 Mar 2024Review(s) Completed, Editorial Evaluation Pending
17 Mar 2024Editorial Decision: Revise Minor
04 Apr 20241st Revision Received