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0:01

I want to show a quick example of allergic fungal sinusitis

0:05

and one of its complications. With allergic fungal sinusitis,

0:08

as I mentioned,

0:09

you tend to see the infection in bilateral and multiple sinuses.

0:16

So in this case, we see that there is hyperdense

0:19

secretions in the right maxillary antrum.

0:22

We see that there is expansion of the maxillary sinus ostium

0:25

by the fungal polyps that are involving the

0:30

maxillary antrum and the ostiomeatal unit.

0:33

You notice also that there is hyperdense secretions in the

0:37

ethmoid sinus, and these hyperdense secretions of the

0:40

ethmoid sinus are obstructing the frontal ethmoidal recess or

0:44

what some people refer to as the

0:46

nasofrontal or frontal nasal duct.

0:48

Now, this patient shows marked expansion of

0:54

the frontal sinus with thinning of the bone.

0:58

This is not an acute process,

1:00

this is a long standing process secondary to the obstruction

1:04

of the outflow from the right frontal sinus, leading to

1:07

expansion of that sinus in what we call a mucocele.

1:11

Now, the etiology of the mucocele is the fungal

1:14

polyps and the allergic fungal sinusitis,

1:17

but the process that is indenting the brain tissue

1:22

and sometimes even causing hypoglobus.

1:25

By hypoglobus, we mean that the globe is pushed downward and

1:29

this expansion of the frontal sinus may displace

1:33

the globe downward, as you can see here,

1:36

with the periosteum being displaced downward, leading to

1:41

the globe on the right side, being lower in

1:44

position than the globe on the left side.

Case: Allergic Fungal Sinusitis with Mucocele

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0:01

I want to show a quick example of allergic fungal sinusitis

0:05

and one of its complications. With allergic fungal sinusitis,

0:08

as I mentioned,

0:09

you tend to see the infection in bilateral and multiple sinuses.

0:16

So in this case, we see that there is hyperdense

0:19

secretions in the right maxillary antrum.

0:22

We see that there is expansion of the maxillary sinus ostium

0:25

by the fungal polyps that are involving the

0:30

maxillary antrum and the ostiomeatal unit.

0:33

You notice also that there is hyperdense secretions in the

0:37

ethmoid sinus, and these hyperdense secretions of the

0:40

ethmoid sinus are obstructing the frontal ethmoidal recess or

0:44

what some people refer to as the

0:46

nasofrontal or frontal nasal duct.

0:48

Now, this patient shows marked expansion of

0:54

the frontal sinus with thinning of the bone.

0:58

This is not an acute process,

1:00

this is a long standing process secondary to the obstruction

1:04

of the outflow from the right frontal sinus, leading to

1:07

expansion of that sinus in what we call a mucocele.

1:11

Now, the etiology of the mucocele is the fungal

1:14

polyps and the allergic fungal sinusitis,

1:17

but the process that is indenting the brain tissue

1:22

and sometimes even causing hypoglobus.

1:25

By hypoglobus, we mean that the globe is pushed downward and

1:29

this expansion of the frontal sinus may displace

1:33

the globe downward, as you can see here,

1:36

with the periosteum being displaced downward, leading to

1:41

the globe on the right side, being lower in

1:44

position than the globe on the left side.

Report

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Tags

Paranasal sinuses

Neuroradiology

Infectious

Head and Neck

Emergency

CT

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