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影响单侧孤立性真菌性蝶窦炎诊断的因素分析

Analysis of factors affecting diagnosis of unilateral isolated fungal sphenoid sinusitis.

作者信息

Wang Yan, Chen Xiumei, Li Dajian, Zhang Yu, Sun Yan, Song Xicheng

机构信息

Department of Otorhinolaryngology, Head, and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong Province, China.

Shandong Provincial Key Laboratory of Neuroimmune Interaction and Regulation, Yantai, Shandong Province, China.

出版信息

SAGE Open Med. 2024 Dec 17;12:20503121241308694. doi: 10.1177/20503121241308694. eCollection 2024.

DOI:10.1177/20503121241308694
PMID:39698144
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11653436/
Abstract

BACKGROUND

To analyze the characteristics and factors influencing the diagnosis of unilateral isolated fungal sphenoid sinusitis.

METHODS

A retrospective analysis was conducted on the clinical data of patients who underwent surgery for unilateral isolated sphenoid sinusitis between June 2020 and May 2023. Data collected included variables such as gender, age, side of the specimen, symptoms, sinus computed tomography findings, pathological results, and complications. The patients were categorized into two groups: the sphenoid sinusitis group and the fungal sphenoid sinusitis group.

RESULTS

Among the 84 cases studied, there were 19 males (22.6%) and 65 females (77.4%). Inflammation was observed in 11 patients (13.1%), while fungi were detected in 73 patients (86.9%). Headache was reported in 74 cases (88.1%). Sinus computed tomography findings revealed calcified plaques/spots in 51 cases (60.7%), hyperosteogeny in 75 cases (89.3%), and bone destruction in 11 cases (13.1%). The thickness of the sinus wall ranged from 0.92 to 7.35 mm. The thickness ratio of the bilateral sinus walls ranged from 0.80 to 6.78. The chi-square test indicated significant differences between the two groups in terms of calcified plaques/spots, hyperosteogeny, the thickness of the lesion-side sinus wall, and the ratio of bilateral sinus walls ( < 0.05). Diagnostic tests using the ROC curve demonstrated that calcified plaques/spots, the thickness of the lesion-side sinus wall, and the ratio of bilateral sinus walls had moderate accuracy in diagnosing fungal sphenoid sinusitis.

CONCLUSION

While headache is not a specific symptom of fungal sphenoid sinusitis, sinus computed tomography findings such as calcified plaque/spots, the thickness of the lesion-side sinus wall, and the thickness ratio of bilateral sinus walls are valuable for diagnosis.

摘要

背景

分析单侧孤立性真菌性蝶窦炎的诊断特点及影响因素。

方法

对2020年6月至2023年5月期间接受单侧孤立性蝶窦炎手术患者的临床资料进行回顾性分析。收集的数据包括性别、年龄、标本侧别、症状、鼻窦计算机断层扫描结果、病理结果及并发症等变量。将患者分为两组:蝶窦炎组和真菌性蝶窦炎组。

结果

在研究的84例病例中,男性19例(22.6%),女性65例(77.4%)。11例(13.1%)观察到炎症,73例(86.9%)检测到真菌。74例(88.1%)报告有头痛症状。鼻窦计算机断层扫描结果显示51例(60.7%)有钙化斑块/斑点,75例(89.3%)有骨质增生,11例(13.1%)有骨质破坏。窦壁厚度为0.92至7.35毫米。双侧窦壁厚度比为0.80至6.78。卡方检验表明两组在钙化斑块/斑点、骨质增生、病变侧窦壁厚度及双侧窦壁比值方面存在显著差异(<0.05)。使用ROC曲线进行的诊断试验表明,钙化斑块/斑点、病变侧窦壁厚度及双侧窦壁比值在诊断真菌性蝶窦炎方面具有中等准确性。

结论

虽然头痛不是真菌性蝶窦炎的特异性症状,但鼻窦计算机断层扫描结果如钙化斑块/斑点、病变侧窦壁厚度及双侧窦壁厚度比等对诊断有重要价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cefd/11653436/86a73164983d/10.1177_20503121241308694-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cefd/11653436/aff620ccff86/10.1177_20503121241308694-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cefd/11653436/d932dc45a552/10.1177_20503121241308694-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cefd/11653436/b177a94c409d/10.1177_20503121241308694-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cefd/11653436/86a73164983d/10.1177_20503121241308694-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cefd/11653436/aff620ccff86/10.1177_20503121241308694-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cefd/11653436/d932dc45a552/10.1177_20503121241308694-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cefd/11653436/b177a94c409d/10.1177_20503121241308694-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cefd/11653436/86a73164983d/10.1177_20503121241308694-fig4.jpg

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Characterization of fungus ball CT-hyperdensities within maxillary and sphenoid sinuses.上颌窦和蝶窦真菌球 CT 高密度影的特征。
Dentomaxillofac Radiol. 2022 Sep 1;51(6):20180384. doi: 10.1259/dmfr.20180384. Epub 2022 Jul 6.
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The clinical features of endoscopic treated isolated sphenoid sinus diseases.内镜治疗孤立性蝶窦疾病的临床特征
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Clinical pattern of fungal balls in the paranasal sinuses: our experience with 70 patients.鼻窦真菌球的临床模式:我们对70例患者的经验。
Eur Arch Otorhinolaryngol. 2019 Apr;276(4):1035-1038. doi: 10.1007/s00405-018-5258-z. Epub 2019 Jan 3.
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