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Bony Changes in a Unilateral Maxillary Sinus Fungal Ball
Young Joon Jun1, Jae Min Shin2, Jae Yong Lee3
1Department of Otorhinolaryngology-Head and Neck Surgery, Gumi Hospital, Soonchunhyang University College of Medicine.
Objectives:
In the paranasal sinus fungal ball (SFB), changes that occur in the underlying bone have not been well described. Recently, bacterial coinfection has been reported in patients with paranasal SFB. We evaluated whether bone changes occur in patients with unilateral maxillary SFB, and also how bacteria in an SFB affect the bony wall of the sinus.
Methods:
A retrospective study of patients with a unilateral maxillary SFB undergoing endoscopic sinus surgery was conducted from July 2009 to December 2015. Preoperative computed tomography images of the patients were reviewed. Wall thickness (WT) and wall density (WD) of the diseased sinus were measured and compared to the normal sinus. Specimens of the sinus aspirates were obtained during surgery for aerobic and anaerobic cultures.
Results:
Forty-three patients were included (mean, 55.7 ± 12.8 years). Thirty-one cultures (72.1%) were positive for bacteria. Thickening was evident in the anterior, lateral, and posterior walls of the diseased sinus. The average WT was 1.69 ± 0.45 mm on the diseased sinus and 1.14 ± 0.31 mm on the normal sinus (P < 0.001). In the diseased sinus, the difference in the average WT between the culture-positive and culture-negative groups was not significant (P = 0.44). The average WD on the diseased sinus was higher than that on the normal sinus (P < 0.001).
Conclusions:
Osteitic change occurred in most patients with a unilateral maxillary SFB. The presence of bacteria in sinus secretions does not greatly affect the development of osteitic changes in unilateral maxillary SFB.
Insights
Osteitic changes, or bone inflammation, are common in patients with unilateral maxillary sinus fungal balls (SFB). Bacterial presence in SFB does not significantly influence the development of these bone changes.
Area of Science:
- Otolaryngology
- Medical Imaging
- Infectious Diseases
Background:
- Bone changes in sinus fungal balls (SFB) are not well-documented.
- Bacterial coinfection has been recently observed in SFB cases.
Purpose of the Study:
- To investigate bone changes in patients with unilateral maxillary SFB.
- To determine the impact of bacterial presence on the bony wall of the sinus.
Main Methods:
- Retrospective analysis of 43 patients with unilateral maxillary SFB undergoing endoscopic sinus surgery.
- Preoperative CT scans were used to measure wall thickness and density of the diseased versus normal maxillary sinus.
- Sinus aspirate cultures were performed to identify bacterial presence.
Main Results:
- Osteitic changes, characterized by increased wall thickness and density, were observed in the diseased maxillary sinus compared to the normal side (P < 0.001).
- Bacterial cultures were positive in 72.1% of patients.
- No significant difference in wall thickening was found between culture-positive and culture-negative groups (P = 0.44).
Conclusions:
- Osteitic changes are prevalent in unilateral maxillary SFB.
- Bacterial coinfection does not significantly alter the development of osteitic changes in SFB.
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