The authors reviewed the cases of aspergillosis of the paranasal sinuses which were seen at the Jikei University Hospital (11 cases) during the period from January 1976 to August 1981 and which appeared in the Japanese literature (34 cases) as to clinical features, diagnosis, etiology and treatments.
The clinical features were as follows: 1) in all cases aspergillosis of the paranasal sinuses occurred unilaterally, 2) a necrotic granulation mass was often seen in the middle nasal meatus, 3) bone erosions or defects were often seen in the medial wall of the maxillary sinus, 4) most of the patients were middle aged, 5) the signs and symptoms included postnasal discharge, toothache, headache, nosebleed, nasal obstruction, nasal discharge and pain of the face.
The diagnosis can usually be obtained by clinical and histopathological examinations. In a few cases which can not be differentiated from malignancy an exploratory sinusotomy should be done.
Etiological factors may be classified into systemic, local and parasite factors. Since aspergillosis, almost in all cases, occurs unilaterally it seems that the local factors are of primary importance and the systemic and parasite faccors are of secondary.
It is assumed that Aspergillus fumigatus enters into the nasal cavity and proliferate around the fontanelle. The treatment of choice is irrigation of the maxillary sinus or surgical removal of the lesion.
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