Abstract:Objective To explore the early diagnosis of fungal sphenoidal sinusitis with initial ocular symptoms and navigation-assisted endoscopic surgery for the fungal lesion resection. Methods A retrospective study was conducted on clinical data of 17 fungal sphenoidal sinusitis cases with initial ocular symptoms hospitalized in the Department of Otorhinolaryngology from January 2007 to December 2022. The collected data including symptoms, radiographic imaging, surgical records, pathologic diagnosis and postoperative outcomes were analyzed. Results Preoperative radiographic imagings of all the 17 patients were considered to be consistent with fungal sphenoidal sinusitis. All patients underwent endoscopic sinus surgery, and fungal sphenoidal sinusitis was confirmed based on histopathological evidence. Ocular symptoms including visual disturbances, eye movement disorder, and blepharoptosis got relieved in 11 patients, while the ocular symptoms of the remaining 6 patients were not significantly improved after surgery. Conclusions Fungal sphenoidal sinusitis should be considered in patients with progressive vision loss and persistent headache. Sinus/brain/ocular computed tomography and/or magnetic resonance imaging should be performed as soon as possible, and once confirmed, endoscopic sinus surgery is the preferred choice. Intraoperative navigation technology can assist in accurately locating the lesions and determining the extent of the lesions, which may ensure the surgical safety and improve surgical efficiency. Combined systemic anti-fungal therapy is critical for the treatment of invasive fungal rhinosinusitis.
