Aspergillosis of the paranasal sinuses

Falworth, Mark; Herold, Jörg

doi:10.1016/s1079-2104(96)80426-4

Cited by 19 publications

(11 citation statements)

References 25 publications

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“…The general CT findings are micro-calcifications or spots with metallic density in sinus fungus ball. Previous literatures [ 1 , 5 , 11 ] show that there are some mental elements such as calcium and zinc in fungus ball and they concluded that those metal elements had a strong correlation with the development of sinus fungus ball. But the origin of those elements is not confirmed.…”

Section: Discussionmentioning

confidence: 99%

“…Various terms such as mycetoma, aspergillosis and aspergilloma had been referred to sinus fungus ball as analogous term in the previous literatures [ 8 , 10 ]. As a saprophytic mold of the ascomycetes class and the dominant fungal pathogen of sinus fungus ball [ 11 , 12 ], Aspergillus is widely distributed in the environment and can be found in soil, cereals, and decaying vegetation [ 11 ]. Aspergillus spores might be inhaled with breathing and stay on mucosa membrane of nasal cavity and paranasal sinuses, which are unlikely to cause disease if the individual is in healthy condition.…”

Section: Introductionmentioning

confidence: 99%

“…Due to lack of non-specific clinical presentation, most patients are suspected as sinus fungus ball only in case of difficult to treat or recurrent unilateral sinusitis [ 10 , 11 ]. In such situations, computed tomography (CT) scan becomes the necessary imaging choice.…”

Section: Introductionmentioning

confidence: 99%

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A Preliminary Study on Sinus Fungus Ball with MicroCT and X-Ray Fluorescence Technique

et al. 2016

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BackgroundSinus fungus ball, an accumulation of fungal dense concretions, is a common disease in practice, and might cause fatal complications or lead to death once converted into invasive type. Early preoperative diagnosis of this disease can lead to appropriate treatment for patients and prevent multiple surgical procedures. Up to now, the diagnostic criteria of sinus fungus ball have been defined and computed tomography (CT) scan was considered as a valuable preoperative diagnostic tool. However, the sensitivity of clinical CT is only about 62%. Thus, investigating the factors which influence sensitivity is necessary for clinical CT to be a more valuable preoperative diagnosis tool. Furthermore, CT scan usually presents micro-calcifications or spots with metallic density in sinus fungus ball. Previous literatures show that there are some metallic elements such as calcium and zinc in fungus ball, and they concluded that endodontic treatment has a strong correlation with the development of maxillary sinus fungus ball and zinc ion was an exogenous risk factor. But the pathogenesis of sinus fungus ball still remains unclear because fungus ball can also develop in other non-maxillary sinuses or the maxillary sinus without root canal treatment. Is zinc ion the endogenous factor? Study on this point might be also helpful for investigating the pathogenesis of sinus fungus ball. In this paper, we tried to investigate the factors which influence the sensitivity of clinical CT by imaging sinus fungus ball with microCT. The origin of zinc ion was also studied through elements test for different fungal ball samples using x-ray fluorescence technique.MethodsSpecimens including fungal ball material and sinus mucosa from patients confirmed by pathological findings were extracted after surgery. All fungal ball specimens came from sphenoid sinus, ethmoidal sinus and maxillary sinus with or without previous endodontic treatment respectively. All of them were imaged by microCT with spatial resolution up to 5μm to acquire three-dimensional structure, and then the heavy metal elements were detected with x-ray fluorescence spectrometer analysis.ResultHigh concentration of zinc and calcium were detected in all fungal ball specimens compared to sinus mucosa membrane. Particles with different size varied from disperse to density, which have similar shape to the result of clinical CT but with different size, were found in three-dimensional reconstruction results of microCT.ConclusionsSpatial resolution is an influent factor of clinical CT sensitivity for sinus fungus ball. Improving the resolution of clinical CT will help to improve its sensitivity. Besides iatrogenic endodontic materials, endogenous metal elements of zinc and calcium might associate with the growth of fungal ball and the micro-calcifications or spots with metallic density of CT imaging.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Preliminary Study on Sinus Fungus Ball with MicroCT and X-Ray Fluorescence Technique

et al. 2016

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“…[6] The second route involves an iatrogenic model where spores are introduced into antrum via an oroantral communication formed due to root canal perforation or dental extraction. [6–8] Once the spores are introduced they act as opportunistic pathogens and colonize the maxillary sinus, particularly when condition that decrease sinus ventilation such as bacterial sinusitis already exist[9] Aspergillosis of paranasal sinuses is commonly seen in normal healthy individual. This condition may present as mycetoma, or occasionally as an invasive form of the disease.…”

Section: Introductionmentioning

confidence: 99%

Invasive aspergillosis in an immunocompetent host

Sethi

Saluja

Jindal

et al. 2012

J Oral Maxillofac Pathol

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“…Despite the enormous diversity among species of Aspergillus , only a few thermotolerant groups are capable of causing an opportunistic infection, known as aspergillosis, in human beings. 1 2 3 Aspergilloma is the most common subtype of aspergillosis; it is defined as noninvasive chronic fungal sinusitis, and is predominantly seen in the maxillary antrum of immunocompetent hosts. 4 Aspergilloma is usually asymptomatic and it may take several years for symptoms to occur.…”

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confidence: 99%

Maxillary sinus aspergilloma of odontogenic origin: Report of 2 cases with cone-beam computed tomographic findings and review of the literature

et al. 2018

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Aspergilloma of the maxillary sinus is considered rare in immunocompetent patients, but a considerable increase has recently been seen in the incidence of reported cases. Dental procedures involving the antral region are thought to predispose individuals to this form of aspergillosis. Because aspergilloma shares similar clinical features with other sinus pathologies, its diagnosis may be delayed. Thus, an early diagnosis confirmed by a histopathological examination plays a crucial role in the adequate management of aspergilloma. This article provides a concise review of the reported cases of aspergilloma associated with dental procedures and reports 2 new cases of aspergilloma in middle-aged female patients, with a presentation of their cone-beam computed tomographic findings.

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Aspergillosis of the paranasal sinuses

Cited by 19 publications

References 25 publications

A Preliminary Study on Sinus Fungus Ball with MicroCT and X-Ray Fluorescence Technique

A Preliminary Study on Sinus Fungus Ball with MicroCT and X-Ray Fluorescence Technique

Invasive aspergillosis in an immunocompetent host

Maxillary sinus aspergilloma of odontogenic origin: Report of 2 cases with cone-beam computed tomographic findings and review of the literature

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