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Background and Objectives: The purpose of this study was to classify radiological findings of patients diagnosed with maxillary sinus fungus ball and to analyze the differences in surgical approach methods and postoperative results.Methods: As a retrospective study, we reviewed the medical records of 221 patients (unilateral in 216: bilateral in 5).Results: On computed tomography (CT), 49% of the lesions had an irregular surface or a protruding part. There was a significant difference in surgical approach according to pneumatization of the maxillary sinus when middle meatal antrostomy (MMA) was performed alone or combined with MMA and inferior meatal antrostomy (IMA) (p=0.042). Extension of a maxillary sinus lesion caused by fungus ball was not associated with stenosis of the MMA (p=0.328).Conclusion: Diagnosis of maxillary sinus fungus on CT was associated with irregular lesion surface or a protruding calcification. In patients with fungus ball of the maxillary sinus, the more severe is the maxillary sinus pneumatization, the larger is the extent of IMA needed.

Clinical Characteristics According to the Radiological Classifications of Maxillary Sinus Fungus Ball