title: Association between maxillary sinus fungus ball and sinus bone grafting with deproteinized bovine bone substitutes: a case-control study.
abstract: OBJECTIVE
  To evaluate the association between sinus bone graft and the development of fungus ball (FB) of the maxillary sinus.
  
  
  METHODS
  The charts of all patients seen for surgical treatment of maxillary sinus FB following sinus bone grafting between 2006 and 2014 were reviewed. The charts of 49 participants were selected from our internal registry for comparison as controls. The association between FB and age, gender, smoking habits, associated co-morbidities, and bone grafting material was evaluated. FB of the maxillary sinus was estimated by using an odds ratio with a Yates' correction. P values were computed using Fisher's exact test, and the statistical significance was set at a P value < .05.
  
  
  RESULTS
  All 13 cases (100%) with FB of the maxillary sinus had received anorganic bovine bone as the bone substitute (P = .0001). There were significantly more women in the case group than in the control group (84.6% in the cases vs 40.8% in the controls; P = .01).
  
  
  CONCLUSIONS
  This study demonstrated a significant association between a specific deproteinized bovine bone substitute use as sinus bone graft material and subsequent development of FB of the maxillary sinus.
authors.affiliation: Head, Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland. Electronic address: Paolo.scolozzi@hcuge.ch.
authors.forename: Paolo
authors.initials: P
authors.lastname: Scolozzi
authors.affiliation: Resident, Division of Oral and Maxillofacial Surgery, Unit of Oral Surgery and Implantology, Department of Surgery, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Perez
authors.affiliation: Maxillofacial Surgeon, Private Practice, Fribourg, Switzerland.
authors.forename: Raul
authors.initials: R
authors.lastname: Verdeja
authors.affiliation: Biostatistician, CRC & Division of Clinical Epidemiology, Department of Health and Community Medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Delphine S
authors.initials: DS
authors.lastname: Courvoisier
authors.affiliation: Head, Division of Oral and Maxillofacial Surgery, Unit of Oral and Maxillofacial Medicine and Pathology, Department of Surgery, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Lombardi
mesh_terms: D000818:Animals; D001228:Aspergillosis / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000601:surgery; D001230:Aspergillus / Q000302:isolation & purification*; D018786:Bone Substitutes / Q000009:adverse effects*; D016025:Bone Transplantation; D016022:Case-Control Studies; D002417:Cattle; D005260:Female; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery*; D015523:Maxillary Sinusitis / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D018786:Bone Substitutes