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Clinical features in maxillary sinus fungus ball in patients with malignant hematological disease

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Previous studies on fungus balls have primarily focused on immunocompetent patients, and only a few studies have described the clinical characteristics of fungus balls in malignant hematological disease (MHD) patients. Therefore, we compared the clinical features of maxillary sinus fungus ball (MSFB) between immunosuppressive patients with MHD and immunocompetent patients.

Methods

Twenty patients with MHD and 40 randomly selected immunocompetent patients were enrolled and divided into MHD and non-MHD groups. All patients were diagnosed with MSFB and their clinical features were retrospectively analyzed.

Results

Patients in the MHD group had non-specific clinical symptoms and endoscopic manifestations of MSFB, similar to those in the non-MHD group. On computed tomography (CT), the MHD group showed higher Lund-Mackay scores, lesser single sinus opacifications, more multiple sinus opacifications on the affected side, and more bilateral opacifications compared to the non-MHD group. The MHD group had a lower frequency of central hyper-density and heterogeneous opacifications than the non-MHD group. There were no significant differences between the two groups in terms of the fungal-infected side, lateral sinus wall ratio, sclerosis of the lateral sinus wall, erosion of the inner sinus wall, and nasal septum deviation.

Conclusion

The clinical symptoms and endoscopic manifestations of MSFB in patients with MHD were similar to those of immunocompetent patients. However, more atypical signs and wider mucosal inflammation were found on CT scans of MSFB patients with MHD. These results indicate that caution should be executed when excluding the possibility of fungus balls in immunosuppressive patients.

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Availability of data and material

The datasets used and analyzed during the current study are available on reasonable request.

Code availability

Not applicable.

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Funding

This work supported by Natural Science Foundation of Beijing Municipality (Grant Number: 7202215). The funding organization did not contribute to the design or conduct of this study; preparation, review, approval, or decision to submit this manuscript for publication.

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Author notes

  1. Zhimin Xing and Lisheng Yu are co-corresponding authors for this work.

Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, Peking University People’s Hospital, 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China

    Yang Yang, Zhimin Xing, Lisheng Yu, Xiaopei Yuan, Min Wang, Congli Geng, Yan Liu, Shichang Li & Yuanjun Liu

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  1. Yang Yang
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  2. Zhimin Xing
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  3. Lisheng Yu
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Yang Yang, Zhimin Xing, Lisheng Yu, Xiaopei Yuan, Min Wang, Congli Geng, Yan Liu, Shichang Li and Yuanjun Liu. The first draft of the manuscript was written by Yang Yang and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Zhimin Xing.

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Yang, Y., Xing, Z., Yu, L. et al. Clinical features in maxillary sinus fungus ball in patients with malignant hematological disease. Eur Arch Otorhinolaryngol 279, 1919–1927 (2022). https://doi.org/10.1007/s00405-021-06973-5

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  • DOI: https://doi.org/10.1007/s00405-021-06973-5

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