PMC5242065_01
Computed tomography imaging of congested ostium and radiopaque appearance
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F1
The patient consulted an ENT specialist and computed tomography revealed that the left middle meatus was congested with radiopaque substance [Figure 1].
defluxion from fistula
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F2
Besides, endoscopic sinus examination showed that there was pus drainage from maxillary sinus to inferior meatus through fistula [Figure 2], and augmented amoxicillin with clavulanic acid (Augmentin, 1 g) was prescribed for 2 weeks to control sinusitis.
granulation formation
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F3
After 2 weeks, a granulation tissue in the maxillary sinus was observed during the endoscopic examination [Figure 3], and FESS was performed for decontamination of the maxillary sinus and correction of ostium function.
(a) middle meatal antrostomy, (b) removal of substance located in the maxillary sinus, (c) postoperative appearance of the middle meatus
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F4
Augmented amoxicillin with clavulanic acid (Augmentin, 1 g) was prescribed for 2 weeks again after FESS, and histopathological examination of the substance removed from the sinus revealed aspergillosis [Figure 4a-c].