title: Analysis of sinonasal anatomical variations associated with maxillary sinus fungal balls.
abstract: OBJECTIVE
  The pathogenesis of MSFB development remains unclear, but it has been suggested that poor sinus ventilation is associated with disease development; such a ventilation is influenced by anatomical variation of the paranasal sinuses. Thus, we sought to determine whether sinonasal anatomical variations were associated with MSFB development.
  
  
  METHODS
  Thirty-one patients with MSFB and 28 gender-matched control patients were included in the present study. The presence or absence of Haller cells and a concha bullosa were scored, and the angle of septal deviation and the minimal and maximal lengths of the infundibulum were measured on preoperative computed tomography images.
  
  
  RESULTS
  In the MSFB group, both a concha bullosa (61.3% vs. 28.6%, p=0.006) and Haller cells (41.9% vs. 30.4%) were present at higher frequencies than in the control group, although the between-group difference in Haller cell occurrence was not statistically significant (p=0.348). In addition, MSFB patients had a significantly lower mean infundibular width (3.23±0.69mm vs. 3.99±1.17mm, p<0.001) and a longer infundibular length (9.71±1.43mm vs. 8.23±1.72mm, p<0.001) than controls.
  
  
  CONCLUSIONS
  Sinonasal anatomical variations, especially the presence of a concha bullosa, and/or a narrow and long infundibulum, may play roles in the development of maxillary sinus fungal balls (MSFBs).
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Seoul Hospital, Seoul, Republic of Korea.
authors.forename: Jae-Min
authors.initials: JM
authors.lastname: Shin
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Republic of Korea.
authors.forename: Byung Joon
authors.initials: BJ
authors.lastname: Baek
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Republic of Korea.
authors.forename: Jang Yul
authors.initials: JY
authors.lastname: Byun
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Kumi Hospital, Kyungsangbuk-Do, Republic of Korea.
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Jun
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Republic of Korea. Electronic address: jyent@schmc.ac.kr.
authors.forename: Jae Yong
authors.initials: JY
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D063405:Anatomic Variation; D001228:Aspergillosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D005547:Foreign Bodies / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000000981:diagnostic imaging*; D015523:Maxillary Sinusitis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008875:Middle Aged; D009666:Nose / Q000002:abnormalities / Q000000981:diagnostic imaging; D010256:Paranasal Sinuses / Q000002:abnormalities / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014420:Turbinates / Q000002:abnormalities / Q000000981:diagnostic imaging*
keywords: Fungal ball; Fungal sinusitis; Maxillary sinus; Sinonasal anatomical variations