목적: Fungal ball, constituting 53-72% of fungal sinusitis cases, has witnessed a rising prevalence in recent years worldwide. Predominantly occurring in the maxillary sinus (MS) (86%), complete endoscopic removal is crucial for preventing recurrence. In this study, we evaluate the effectiveness of using a ‘laryngeal mirror’ for enhanced visualization to ensure the complete removal of the MS fungal ball compared with conventional methods. 방법:From Jan 2022 to Dec 2023, medical records of 61 cases pathologically confirmed as MS fungal ball were retrospectively reviewed. All cases were restricted to patients with fungal ball presence only in the MS. Cases involving approaches such as inferior meatal antrostomy, Caldwell-Luc operation, and prelacrimal approach were excluded. In the laryngeal mirror group, a ‘laryngeal mirror’ with a 6 mm diameter was inserted into the maxillary sinus where fungal ball removal had been completed, and a 30- or 70-degree endoscopic field of view was utilized to observe the inside of the maxillary sinus, facilitating the identification and removal of any remnant fungal debris. Parameters including age, gender, size and extent, fungal ball removal techniques, follow-up time, and recurrence rate were investigated. 결과:All surgeries involved middle meatal antrostomy (MMA) and anterior ethmoidectomy. The endoscopic equipment utilized included 0°, 30°, and 70° endoscopes, with the exclusion of fiberoptic endoscopes. Curved suction, curettage, and massive saline irrigation were employed in all cases, and gauze swiping techniques was used in 14 cases. Among the patients, 19 (8 males, 11 females) were treated with a laryngeal mirror, and 42 (17 males, 25 females) were not. A 30° endoscope was used in all 19 patients, and a 70-degree endoscope was used in 7 patients. There was no significant difference in the demographic parameters between the laryngeal mirror group and non-mirror group. However, the laryngeal mirror group had no recurrences while two recurrences were noted in the non-mirror group (p=0.013). 결론:Although the sample size is small, this preliminary report suggests that integrating a 'laryngeal mirror' with endoscopy in MS fungal ball removal could significantly enhance surgical success rates and offer advantages in effective recurrence prevention. We are currently exploring whether this innovative endoscopic field expansion method has potential in addressing other MS diseases which require an MS approach via MMA, not limited to fungal ball cases.