Correlation between fungus ball of maxillary sinus and previous root canal therapy. Case report and narrative literature review

Fungus ball (FB) is a non-invasive mycosis typically found in the paranasal sinuses, predominantly the maxillary sinus. This case report describes the diagnosis and treatment of a recurrent maxillary FB in a 58-year-old patient, managed through Functional Endoscopic Sinus Surgery (FESS) combined with an intraoral approach. The patient presented with chronic unilateral nasal obstruction and recurrent sinusitis, with imaging studies revealing a heterogeneous mass in the left maxillary sinus. Histopathological examination confirmed the presence of a fungal ball. FESS was utilized to ensure minimal invasiveness and precision in removing the fungal mass while preserving normal sinus anatomy. The intraoral approach facilitated the direct access to the maxillary sinus, to complete the debridement required after recurrence from the first line FESS treatment. Postoperative follow-up showed significant symptomatic relief and no recurrence of the fungal ball. This case highlights the efficacy of combining FESS with an intraoral approach in treating maxillary fungal balls recurrence, emphasizing the importance of a tailored surgical strategy to achieve optimal Results. The combined approach not only ensures complete removal of the fungal mass but also minimises complications and enhances patient recovery.