Department of Otolaryngology-Head & Neck Surgery, 6886Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
43939Sutter Gould Medical Foundation, Stockton, CA, USA.
Ear Nose Throat J. 2021 Jan;100(1):55-59. doi: 10.1177/0145561319840853. Epub 2019 Jun 2.
Invasive fungal sinusitis is a morbid pathology that typically affects immunocompromised patients and may quickly progress to fulminant disease. The purpose of this study was to measure the sensitivity and specificity of touch preparation of nasal debridement specimens as a rapid diagnostic tool for invasive fungal sinusitis. A retrospective chart review was performed of 22 patients undergoing nasal debridement due to suspicion for invasive fungal sinusitis over a 10-year period. Thirteen patients had touch preparation of nasal specimens followed by routine histologic processing; two of these patients underwent 2, and 1 patient had 3 separate debridements, for a total of 17 touch preparations performed. The sensitivity and specificity of touch preparation were calculated by correlating the initial results with the presence of fungal invasion on final pathologic analysis. The sensitivity of touch preparation was 56% (95% confidence interval [CI]: 0.23-0.85), specificity was 100% (95% CI: 0.60-1.00), positive predictive value was 100% (95% CI: 0.46-1.00), and negative predictive value was 67% (95% CI: 0.35-0.89). This procedure may be a useful adjunct in situations requiring rapid diagnosis of invasive fungal sinusitis but should not be used as the sole criteria for determining the need for surgical intervention.
侵袭性真菌性鼻窦炎是一种病态病理学，通常影响免疫功能低下的患者，并可能迅速发展为暴发性疾病。本研究旨在测量鼻清创标本触诊作为侵袭性真菌性鼻窦炎快速诊断工具的敏感性和特异性。对过去 10 年中因怀疑侵袭性真菌性鼻窦炎而行鼻清创术的 22 例患者进行了回顾性图表审查。13 例患者进行了鼻标本触诊，随后进行常规组织学处理；其中 2 例患者进行了 2 次，1 例患者进行了 3 次单独清创，共进行了 17 次触诊。通过将初始结果与最终病理分析中真菌侵袭的存在相关联，计算触诊的敏感性和特异性。触诊的敏感性为 56%（95%置信区间[CI]：0.23-0.85），特异性为 100%（95%CI：0.60-1.00），阳性预测值为 100%（95%CI：0.46-1.00），阴性预测值为 67%（95%CI：0.35-0.89）。在需要快速诊断侵袭性真菌性鼻窦炎的情况下，该程序可能是一种有用的辅助手段，但不应作为确定是否需要手术干预的唯一标准。
