case_images: PMC11719722_01
case_images: Coronal (A) and axial (B) images of a nonenhanced CT scan of the paranasal sinuses showing left sphenoid sinus complete homogenous opacification.
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case_images: The patient underwent a non-contrast paranasal sinus CT scan (Fig. 1) that demonstrated an isolated sphenoid sinus homogenous opacification, most likely representing sphenoid fungal ball.
case_images: Intra-operative (A and B) endoscopic sphenoidotomy showing fungal debris, with post-operative examination (C) showing clean wide sphenoid sinus free from fungal debris.
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case_images: A decision was made to proceed with endoscopic sphenoidotomy (Fig. 2) to clean and remove the debris, which confirmed the diagnosis of sphenoid sinus fungal ball.
case_images: PMC11719722_02
case_images: Coronal CT scan image showing complete sphenoid sinus heterogenous opacification.
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case_images: A subsequent CT scan revealed isolated sphenoid sinus disease (Fig. 3).
case_images: Intra-operative (a, b, and c) endoscopic sphenoidotomy showing mud and mucin, with post-operative examination (d) of right optico-carotid recess showing wide and clean sphenoid sinus.
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case_images: Intra-operative endoscopic findings revealed fungal mud and mucin (Fig. 4A and B) with post-operative (Fig. 4C) endoscopic finding of widely open, clean sphenoid sinus.
case_images: PMC11719722_03
case_images: Coronal CT (A) and MRI (B) and CT image guided intra-operative (C) images of the paranasal sinuses showing aggressive sphenoid sinus disease extending to the skull base and cavernous sinus.
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case_images: An initial CT scan with a subsequent MRI scan (Fig. 5) showed infiltrative sphenoid pathology invading both skull base and cavernous sinus given a provisional diagnosis of acute invasive fungal sinusitis.
case_images: Intra-operative endoscopic view of shenoid sinus debridement of invasive fungal disease.
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case_images: The patient was urgently taken to the operative theater to endoscopically debride sphenoid sinuses (Fig. 6).