Sinonasal polyposis with secondary fungal infection
Nasal obstruction and headache for a long period.
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Diffuse extensive marked mucosal thickening and almost total soft tissue opacification of the sphenoid and frontal sinuses, both maxillary antra as well as the ethmoidal complexes on both sides, that appears merging with the nasal turbinates and partially obliterating the nasal cavities.
Soft tissue window images show hyperdensity material within the nasal cavity and both maxillary antra suggesting fungal infection (proved histopathologically).
Note: right temporal arachnoid cyst is seen.
Chronic rhinosinusitis is defined as disease lasting more than 12 weeks 1.
Fungal infection is relatively common and is broadly divided into invasive and non-invasive forms, defined by the presence or absence of fungal hyphae in the mucosa and soft tissues of the sinonasal cavity 2.
CT characteristically demonstrates multiple sinus opacification with sinus expansion and the presence of hyperdense material. Benign bony remodelling, resorption and erosion into adjacent
structures can be seen 3,4.
- 1-Lanza DC, Kennedy DW. Adult rhinosinusitis defined.Otolaryngol Head Neck Surg 1997;117:S1–S7.
- 2- deShazo RD, O’Brien M, Chapin K, Soto-Aguilar M, GardnerL, Swain R. A new classification and diagnostic criteria for invasive fungal sinusitis. Arch Otolaryngol Head Neck Surg 1997;123:1181–8.
- 3- Mukherji SK, Figueroa RE, Ginsberg LE, Zeifer BA, Marple BF, Alley JG, et al. Allergic fungal sinusitis: CT findings.Radiology 1998;207:417–22.
- 4- Al-Dousary SH. Allergic fungal sinusitis: radiological and microbiological features of 59 cases. Ann Saudi Med 2008; 28:17–21.