# The simultaneous occurrence of a fungal ball in maxillary and sphenoid sinuses: a case report and review of the literature

## TL;DR

This case report describes a rare instance of a fungal ball occurring simultaneously in two sinuses and highlights the diagnostic and treatment approaches.

## Contribution

The novelty lies in documenting a rare case of concurrent fungal balls in both maxillary and sphenoid sinuses.

## Key findings

- A 52-year-old woman presented with symptoms consistent with fungal balls in both maxillary and sphenoid sinuses.
- CT scan PNS and histopathological evaluation confirmed the presence of fungal balls.
- Endonasal endoscopic sinus surgery is recommended as the gold standard treatment.

## Abstract

A fungal ball is most frequently found in the maxillary sinus, though it can also occur in the sphenoid, ethmoid, and frontal sinuses. This study aims to demonstrate the pathological conditions and clinical features of a patient with unilateral left maxillary and sphenoid sinus fungal balls. A 52-year-old woman arrived with complaints of headache, facial pain, and post-nasal discharge. An endonasal endoscopic examination was unremarkable. However, the plain paranasal sinuses computerized tomography scan (CT scan PNS) of the patient revealed two simultaneous opacities occupying both the maxillary and sphenoid sinuses with calcification indicating a fungal ball occupying. Even with the advancing diagnostic methods and investigations, detecting a fungal ball remains difficult. A CT scan PNS and a nasal endoscopy with histopathological evaluation are considered useful and specific. Endonasal endoscopic sinus surgery is the gold standard, with a high success rate and low morbidity rate.