Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Bordeaux, Bordeaux, France.
Department of Otorhinolaryngology-Head and Neck Surgery, King Abdulaziz University, Jeddah, Saudi Arabia.
Dentomaxillofac Radiol. 2022 Sep 1;51(6):20180384. doi: 10.1259/dmfr.20180384. Epub 2022 Jul 6.
CT-scan hyperdensities (HD) are described in more than 60% of all paranasal sinus fungus ball (FB) cases. Two types can be distinguished according to their density: calcium and metal types. We aimed to establish the prevalence and density of the HD observed in sphenoid and maxillary sinus FB and their relation to dental factors.
This retrospective study included 64 patients operated in a tertiary referral center for unilateral maxillary or sphenoid FB diagnosed by histology or mycology. Pre-operative CT scans were analyzed by three independent observers (two ENT and one radiologist).
There were 45 maxillary FB and 19 sphenoid FB. 63 FB showed HD. Metal-type HD were observed in 28 maxillary FB but not in sphenoid sinuses. Among maxillary FB, the prevalence of endodontic treatment was significantly more significant on the FB side than on the healthy side ( = 0.02). The prevalence of endodontic treatment on the pathological side was more significant in the metal-type group than in the group without metal-type HD ( = 0.01). Isolated calcium-type HD were evidenced in 17 maxillary FB and 18 sphenoid FB ( = 0.019).
This study highlights the existence of two different types of HD in FBs of the paranasal sinuses with an association between metal-type HD and endodontic treatments.
CT 扫描高密度（HD）在超过 60%的所有鼻窦真菌球（FB）病例中均有描述。根据其密度，可将其分为两类：钙型和金属型。我们旨在确定蝶窦和上颌窦 FB 中观察到的 HD 的患病率和密度及其与牙齿因素的关系。
本回顾性研究纳入了在三级转诊中心接受单侧上颌窦或蝶窦 FB 手术的 64 例患者，这些 FB 通过组织学或真菌学诊断。由三位独立的观察者（两位 ENT 和一位放射科医生）对术前 CT 扫描进行分析。
45 例为上颌窦 FB，19 例为蝶窦 FB。63 例 FB 显示有 HD。28 例上颌窦 FB 中存在金属型 HD，但蝶窦中不存在。在上颌窦 FB 中，患侧接受根管治疗的患病率明显高于健侧（ = 0.02）。在金属型 HD 组中，患侧接受根管治疗的患病率明显高于无金属型 HD 组（ = 0.01）。17 例上颌窦 FB 和 18 例蝶窦 FB 中存在孤立的钙型 HD（ = 0.019）。
本研究强调了鼻窦 FB 中存在两种不同类型的 HD，且金属型 HD 与根管治疗之间存在关联。
