Removal of fungal ball from the jaws by lefort i osteotomy: Difficulty in diagnosing patients with chronic sinusitis

Abstract

Aspergillosis, aka fungal ball (FB), is classified as a type of non-invasive fungal rhinosinusitis, which usually occurs unilaterally in the maxillary sinus of an immunocompromised patient. Its diagnosis is complex and depends on the association between clinical, imaging, and histopathological exams. There are many treatments for fungal infections of the paranasal sinuses, so early diagnosis is extremely important to determine the appropriate treatment. This paper reports an unusual clinical case of aspergillosis present bilaterally inside the maxillary sinuses of a healthy patient, associated with mucous retention cysts, whose imaging exams and transnasal endoscopy were not sufficient to precisely identify the lesion. Its diagnosis and definitive treatment were obtained only after orthognathic surgery and integration between a multidisciplinary team.