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  Nasal Fungal Balls: Etiology, Diagnosis, and Management – An Expert Review Introduction Nasal fungal balls, also referred to as fungal mycetomas of the paranasal sinuses, are a non-invasive form of fungal sinusitis characterized by dense, matted fungal hyphae accumulating within a sinus cavity, most frequently the maxillary sinus. Although often asymptomatic, these lesions can lead to chronic sinonasal symptoms and are occasionally discovered incidentally during imaging for unrelated conditions. Early recognition is crucial, as untreated cases may progress to more aggressive fungal infections in immunocompromised individuals. Etiology and Cause Nasal fungal balls are typically caused by saprophytic fungi , most commonly Aspergillus fumigatus . The pathogenesis is believed to involve: Impaired sinus drainage leading to fungal colonization Pre-existing sinonasal anatomical variations Chronic mucosal inflammation Prior dental procedures introduced foreign material ...