Clinical Characteristics Other Than Intralesional Hyperdensity May Increase the Preoperative Diagnostic Accuracy of Maxillary Sinus Fungal Ball

Hyun Kyung Chang; 송윤재; 배윤정; 원태빈; 김정훈; 조성우; 이재서

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자료유형: 학술저널

저자정보: Hyun Kyung Chang 송윤재 배윤정 원태빈 김정훈 조성우 이재서

저널정보: 대한이비인후과학회 Clinical and Experimental Otorhinolaryngology Clinical and Experimental Otorhinolaryngology 제13권 제2호

발행연도: 2020.1

수록면: 157 - 163 (7page)

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Objectives. This study aimed to evaluate the clinical characteristics of maxillary sinus fungus ball (MFB) to increase the preoperative diagnostic accuracy. Methods. A retrospective review of 247 patients who underwent endoscopic sinus surgery for unilateral maxillary sinusitis from January 2015 to December 2017 at a single institution was performed. Patients with pathologically proven MFB were compared to those with unilateral chronic maxillary sinusitis (CMS). Patient demographics and computed tomography (CT) findings were evaluated. The CT features were categorized as intralesional hyperdensity (calcification), the irregular lobulated protruding lesion (fuzzy appearance), maxillary sinus full haziness without mass effect, maxillary sinus full haziness with mass effect, and others. A regression tree analysis was performed. Results. In total, 247 patients were analyzed; among them, 179 (72.5%) had MFB and 68 (27.5%) had CMS. MFB showed predominance in older individuals. Among the radiological features, intralesional hyperdensity was most commonly associated with MFB. The presence of a fuzzy appearance or full opacity with mass effect was also associated with MFB. The highest area under the curve was noted with the regression tree analysis based on the model, which included the presence of intralesional hyperdensity, demographic data (age), and presence of fuzzy appearance or maxillary sinus full haziness with mass effect in case of absence of intralesional hyperdensity (0.904). Conclusion. A simple algorithm to optimize the preoperative diagnosis of MFB was developed. Physicians should be aware of such findings in the management of patients presenting with unilateral CMS.

참고문헌 (26)

참고문헌 신청

Dufour X / 2006 / Paranasal sinus fungus ball : epidemiology, clinical features and diagnosis : a retrospective analysis of 173 cases from a single medical center in France, 1989-2002 / Med Mycol 44(1):61~67

Jiang RS / 2018 / Characteristics of sinus fungus ball : a unique form of rhinosinusitis / Clin Med Insights Ear Nose Throat 11

Nomura K / 2013 / Sinus fungus ball in the Japanese population : clinical and imaging characteristics of 104 cases / Int J Otolaryngol 2013:731640

Yoon YH / 2017 / A retrospective analysis of 538 sinonasal fungus ball cases treated at a single tertiary medical center in Korea(1996-2015) / Int Forum Allergy Rhinol 7(11):1070~1075

deShazo RD / 1997 / Criteria for the diagnosis of sinus mycetoma / J Allergy Clin Immunol 99(4):475~485

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