Nose and paranasal sinuses: sinus fungus ball: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Nose and paranasal sinuses: sinus fungus ball

Sample item

A 62-year-old immunocompetent woman has chronic unilateral maxillary sinusitis. CT shows opacification with punctate calcifications, and surgery yields a cheesy debris mass without tissue invasion. What is the diagnosis and management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Fungus ball, treated by endoscopic removal without systemic antifungals

A fungus ball (mycetoma), most often Aspergillus in the maxillary sinus, is a non-invasive collection of fungal hyphae in an immunocompetent host. CT shows hyperdense calcifications. Endoscopic removal and ventilation of the sinus is curative, and systemic antifungals are not needed.

Option by option

  • A. Inverted papilloma, treated by radiotherapy

    Inverted papilloma does not show calcified fungal debris.

  • B. Fungus ball, treated by endoscopic removal without systemic antifungals (correct)

    Correct. Non-invasive fungus ball needs surgical clearance.

  • C. Invasive fungal sinusitis, treated by amphotericin

    Invasive disease occurs in immunocompromised patients with tissue invasion.

  • D. Allergic fungal sinusitis, treated by steroids alone

    Allergic fungal sinusitis shows eosinophilic mucin and polyps.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More ENT questions

Questions about this ENT question

What is the answer to this ENT question?

The best answer is B, Fungus ball, treated by endoscopic removal without systemic antifungals. A fungus ball (mycetoma), most often Aspergillus in the maxillary sinus, is a non-invasive collection of fungal hyphae in an immunocompetent host.

Why is "Inverted papilloma, treated by radiotherapy" not the answer?

Inverted papilloma does not show calcified fungal debris.

Why is "Invasive fungal sinusitis, treated by amphotericin" not the answer?

Invasive disease occurs in immunocompromised patients with tissue invasion.

Why is "Allergic fungal sinusitis, treated by steroids alone" not the answer?

Allergic fungal sinusitis shows eosinophilic mucin and polyps.

What concept does this question test?

It tests Nose and paranasal sinuses: sinus fungus ball in ENT. CT shows hyperdense calcifications. Endoscopic removal and ventilation of the sinus is curative, and systemic antifungals are not needed.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Nose and paranasal sinuses: sinus fungus ball?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.