title: Potential correlations of dentogenic factors to the development of clinically verified fungus balls: A retrospective computed tomography-based analysis.
abstract: OBJECTIVE
  Fungus balls are a common disease of the paranasal sinuses, usually involving the maxillary sinus. To clarify the pathology, we analyzed patients treated for maxillary sinus fungus balls to see whether the latter correlated with dentogenic factors.
  
  
  METHODS
  Retrospective case analysis.
  
  
  METHODS
  Cases of maxillary sinus fungus balls diagnosed between January 2000 and December 2013 were analyzed retrospectively. Patients' charts were reviewed for diagnosis, gender, and age. Paranasal sinus computed tomography (CT) scans were reviewed according to the side of the fungus ball, calcifications/opacifications, and dentogenic factors.
  
  
  RESULTS
  In 98/102 patients (96.1%), 157 dentogenic factors could be identified on the side affected by a fungus ball. On the contralateral healthy side, there were 125 dentogenic factors. In four (3.9%) of the patients, no dentogenic pathology was identified on the CT scan. The presence of dentogenic factors (regardless of number) was significantly associated with a fungus ball compared to the healthy side (P = .024, χ(2) test, odds ratio: 2.72 [95% confidence interval: 1.02-7.23]).
  
  
  CONCLUSIONS
  Dentogenic factors regardless of type potentially correlate with the presence of maxillary sinus fungus ball. Unlike the overall presence of dentogenic factors, the particular dentogenic factors in an individual patient do not significantly influence the development of fungus balls. After diagnosis of dentogenic pathology in penetrated maxillary sinus floors, patients should be closely monitored and informed about their higher risk of developing a fungus ball.
authors.affiliation: Department of General Otorhinolaryngology-Head and Neck Surgery.
authors.forename: Peter Valentin
authors.initials: PV
authors.lastname: Tomazic
authors.affiliation: Department of Oral Surgery, University Dental Clinic.
authors.forename: Eva
authors.initials: E
authors.lastname: Dostal
authors.affiliation: Department of Radiology, Medical University of Graz, Graz, Austria.
authors.forename: Marton
authors.initials: M
authors.lastname: Magyar
authors.affiliation: Department of General Otorhinolaryngology-Head and Neck Surgery.
authors.forename: Doris
authors.initials: D
authors.lastname: Lang-Loidolt
authors.affiliation: Department of General Otorhinolaryngology-Head and Neck Surgery.
authors.forename: Axel
authors.initials: A
authors.lastname: Wolf
authors.affiliation: Department of General Otorhinolaryngology-Head and Neck Surgery.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Koele
authors.affiliation: Department of Oral Surgery, University Dental Clinic.
authors.forename: Astrid
authors.initials: A
authors.lastname: Truschnegg
authors.affiliation: Department of General Otorhinolaryngology-Head and Neck Surgery.
authors.forename: Heinz
authors.initials: H
authors.lastname: Stammberger
authors.affiliation: Department of Oral Surgery, University Dental Clinic.
authors.forename: Michael
authors.initials: M
authors.lastname: Payer
mesh_terms: D001228:Aspergillosis / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D005658:Fungi / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000000981:diagnostic imaging* / Q000382:microbiology; D008875:Middle Aged; D010254:Paranasal Sinus Diseases / Q000000981:diagnostic imaging* / Q000382:microbiology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Fungus ball; calcifications; dentogenic; maxillary sinus; mycosis