Periorbital pain induced by the concha bullosa fungus ball: a case report

Fungal ball in concha bullosa as incidentaloma: A case report and the review of the literature

Concha bullosa is an anatomic variant consisting in an enlargement and pneumatization of the middle nasal turbinate. A fungal ball (FB) localized in this structure is an extremely rare disease. This article describes the unusual case of a young patient with an asymptomatic fungal mass in the concha bullosa, incidentally discovered at computed tomography (CT) scan of the head, which was performed after trauma.

Unusual Location of a Fungus Ball: The Concha Bullosa, a Review of the Literature

Introduction

The fungal balls of the paranasal sinuses are usually seen in the maxillary and sphenoid sinuses. Although, the lesion of the concha bullosa, without sinus participation, is very uncommon. We report the case of a fungal ball of concha bullosa in an 88-year-old patient.

Objective

The objective of our review of literature is to investigate the epidemiological, clinical, paraclinical, and therapeutic characteristics of patients diagnosed with fungus ball in concha bullosa.

Methods

A case of a patient who was diagnosed with concha bullosa of a fungus ball is reported. Demographic data, clinical presentation, imaging, and treatments were recorded. Key images were obtained. A review of the literature was also performed.

Results

A total of 12 cases have been reported so far in the literature revealed by different symptoms. The mean age was 38.8 years and the gender ratio was ∼12 (female):1 (male). The endoscopic surgical approach was the most frequently used treatment and provides good outcomes. Neither postoperative complications nor recurrences were noted, however, there is insufficient follow-up data.

Conclusion

Concha bullosa fungal ball is a rare diagnosis that can be revealed by different symptoms. It should be considered in patients with and unexplained chronic facial pain. A preoperative computed tomography scan is an essential tool in making a diagnosis. Endoscopic surgery is the treatment of choice, with a low morbidity and recurrence rate.