Pseudoballs as a distinct endotype of sinonasal bioballs.

IF 1 4区 医学 Q3 OTORHINOLARYNGOLOGY
Hae Won Choi, Sungsin Jo, Taeyang Lee, Junsung Bahn, Jae Kyung Myung, Yangsoon Lee, Mina Rho, Seok Hyun Cho
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引用次数: 0

Abstract

Background: Fungal ball has been known as a noninvasive subtype of chronic rhinosinusitis (CRS). Recently, other endotypes of sinonasal bioballs, which we reported as bacterial balls and mixed balls.

Objectives: This study aimed to investigate the pseudoball as a distinct endotype of sinonassal bioballs.

Methods: This study included 41 CRS patients with suspected fungal balls who underwent functional endoscopic sinus surgery (FESS) from January 2020 to November 2022. All fungus-like biomaterials were stained with Hematoxylin-Eosin, Gomori-Methenamine-Silver (GMS), and Gram stains. Diagnosis of pseudoballs was made when both GMS and Gram staining were negative. Clinical and computed tomography (CT) findings were compared between fungal balls and pseudoballs.

Results: Four endotypes of sinonasal bioballs were identified: fungal balls (56.1%), mixed balls (26.8%), pseudoballs (12.2%), and bacterial balls (4.9%). During FESS, the pseudoballs had heterogeneous gross features with a gel-like or semi-solid consistency and yellow-to-gray colors. Histopathology of the pseudoballs showed a matrix with thick acellular mucous material without any fungi or bacteria. When compared with fungal balls, all pseudoballs cases were immunocompetent (100%) and prone to involvement of the posterior ethmoid sinus (60%, p = 0.01) in CT scans.

Conclusions: The pseudoballs were dual-negative in GMS and Gram staining and showed distinct clinical and radiological characteristics as a different endotype.

假球是鼻窦生物球的一种独特的内型。
背景:真菌球被认为是慢性鼻窦炎(CRS)的一种非侵入性亚型。近年来,我们还报道了其他类型的鼻内生物球,如细菌球和混合球。目的:本研究旨在探讨假球作为鼻窦生物球的一种独特的内型。方法:本研究纳入了41例疑似真菌球的CRS患者,这些患者于2020年1月至2022年11月接受了功能性内窥镜鼻窦手术(FESS)。所有真菌样生物材料用苏木精-伊红、gomori - methamine - silver (GMS)和革兰氏染色进行染色。GMS和革兰氏染色均阴性时诊断假球。比较真菌性球和假性球的临床和CT表现。结果:共检出4种鼻内生物球类型:真菌球(56.1%)、混合球(26.8%)、假球(12.2%)和细菌球(4.9%)。在FESS过程中,假球具有不均匀的大体特征,具有凝胶状或半固体的稠度,颜色为黄至灰色。假球的组织病理学显示基质有厚的脱细胞粘液物质,没有任何真菌或细菌。与真菌性球相比,所有假球病例的CT扫描免疫功能正常(100%),且容易累及后筛窦(60%,p = 0.01)。结论:假球GMS和革兰氏染色双阴性,表现出不同内型的临床和影像学特征。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Acta Oto-Laryngologica
Acta Oto-Laryngologica 医学-耳鼻喉科学
CiteScore
2.50
自引率
0.00%
发文量
99
审稿时长
3-6 weeks
期刊介绍: Acta Oto-Laryngologica is a truly international journal for translational otolaryngology and head- and neck surgery. The journal presents cutting-edge papers on clinical practice, clinical research and basic sciences. Acta also bridges the gap between clinical and basic research.
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