The Endonasal Endoscopic Approach to Different Sinonasal Fungal Balls
Table 2
DeShazo et al.’s [7] diagnostic criteria of fungus ball.
1. Radiological evidence of sinus opacification with or without associated flocculent calcifications
2. Mucopurulent, cheesy, or clay-like material within a sinus
3. A matted, dense conglomeration of hyphae separate from but adjacent to sinus respiratory mucosa
4. A chronic inflammatory response of variable intensity in the mucosa adjacent to fungal elements. This response includes lymphocytes, plasma cells, mat cells, and eosinophils without an eosinophil predominance or a granuloma response. Allergic mucin is absent on hematoxylin-eosin-stained material
5. No histological evidence of fungal invasion of mucosa, associated blood vessels, or underlying bone visualized microscopically on gomori methenamine silver or other special stains for fungus
