A case of aspergillosis of the maxillary sinus after Le Fort I osteotomy

Abstract

Fungal infection of the paranasal sinuses was considered a rare disease in healthy people, but such cases have increased recently because of the use of antibacterial agents, steroid hormones and anticancer drugs. We report a case of aspergillosis of the maxillary sinus after Le Fort I osteotomy.
The patient was an 18-year-old woman in whom mandibular prognathism with facial asymmetry had been corrected by Le Fort I osteotomy and bilateral sagittal split osteotomy. She complained of mild tenderness of the left cheek 3 months after surgery. Postoperative computed tomography showed diffuse radiopacity and a foamy low density area in the left maxillary sinus. Under general anesthesia, the thickened mucosa and necrotic tissue at the bottom of the maxillary sinus were surgically removed. Histopathological examination revealed the presence of sinus aspergillosis. The postoperative course has been good, with no evidence of recurrence.
In this case, alterations of shape and volume of the maxillary sinus associated with Le Fort I osteotomy were considered to have triggered the development of aspergillosis.