{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T16:48:43Z","timestamp":1783183723456,"version":"3.54.6"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,12,24]],"date-time":"2018-12-24T00:00:00Z","timestamp":1545609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005795","name":"Chang Gung Memorial Hospital, Linkou","doi-asserted-by":"publisher","award":["CMRPG3G0061CMRPG3G0671"],"award-info":[{"award-number":["CMRPG3G0061CMRPG3G0671"]}],"id":[{"id":"10.13039\/501100005795","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Maxillary sinus fungus ball (MSFB) is the most common type of noninvasive fungal rhinosinusitis. Surgical removal of the ball achieves good outcomes. Making a rapid and accurate diagnosis is important to avoid unnecessary medical therapy. Intralesional hyperdensity (IH) on computed tomography (CT) is reportedly a good indicator. The aim of this study was to evaluate the diagnostic features of MSFB without IH on preoperative CT images.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective database review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two hundred fifty\u2010eight patients with histopathological evidence of a sinus fungal ball were retrospectively investigated. Forty\u2010seven of 222 patients with MSFB did not show IH on preoperative CT images and were enrolled in the MSFB group. Forty\u2010one patients with unilateral nonfungal chronic rhinosinusitis were enrolled in a control group. CT features previously reported to have diagnostic significance were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sclerosis of the lateral sinus wall, erosion of the inner sinus wall, and irregular surface of the material were significantly more common in the MSFB group than in the control group. In the subgroup of patients with total opacification in the maxillary sinus, the sensitivity, specificity, and positive and negative predictive values for erosion of the inner sinus wall were more than 90%. In the subgroup with partial opacification, the sensitivity, specificity, and positive predictive value of an irregular surface of the material were more than 80%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We have devised an algorithm to help diagnose MSFB without IH on preoperative CT images. Use of this algorithm would improve the diagnostic accuracy and ensure appropriate treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 129:1041\u20131045, 2019<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27670","type":"journal-article","created":{"date-parts":[[2018,12,24]],"date-time":"2018-12-24T08:26:05Z","timestamp":1545639965000},"page":"1041-1045","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Diagnosis of a maxillary sinus fungus ball without intralesional hyperdensity on computed tomography"],"prefix":"10.1002","volume":"129","author":[{"given":"Che\u2010Fang","family":"Ho","sequence":"first","affiliation":[{"name":"Division of Rhinology, Department of Otolaryngology Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Chang Gung Memorial Hospital and Chang Gung University  Keelung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ta\u2010Jen","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Rhinology, Department of Otolaryngology Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7549-9633","authenticated-orcid":false,"given":"Pei\u2010Wen","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Rhinology, Department of Otolaryngology Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Chang Gung Memorial Hospital and Chang Gung University  Keelung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9647-1135","authenticated-orcid":false,"given":"Chi\u2010Che","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Rhinology, Department of Otolaryngology Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan"},{"name":"the Graduate Institute of Clinical Medical Sciences College of Medicine, Chang Gung University  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8725-6209","authenticated-orcid":false,"given":"Po\u2010Hung","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Rhinology, Department of Otolaryngology Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan"},{"name":"the Graduate Institute of Clinical Medical Sciences College of Medicine, Chang Gung University  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen\u2010Lin","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Anatomic Pathology Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yueh\u2010Lin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology Chang Gung Memorial Hospital and Chang Gung University  Keelung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4188-3498","authenticated-orcid":false,"given":"Chien\u2010Chia","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Rhinology, Department of Otolaryngology Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan"},{"name":"the Graduate Institute of Clinical Medical Sciences College of Medicine, Chang Gung University  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,12,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20520"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-007-0281-5"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20578"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-012-1925-7"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-6749(97)70073-3"},{"key":"e_1_2_6_7_1","first-page":"379","article-title":"How to diagnose sinus fungus balls in the paranasal sinus? An analysis of an institution's cases from January 1999 to December 2006","volume":"47","author":"Broglie MA","year":"2009","journal-title":"Rhinology"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22007"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2012.26.3707"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1258\/ar.2011.110021"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0009-9260(05)80083-2"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.2500\/105065800779954446"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199707243370407"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12588"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0148515"},{"key":"e_1_2_6_16_1","first-page":"93","article-title":"Maxillary fungus ball: zinc\u2010oxide endodontic materials as a risk factor","volume":"35","author":"Nicolai P","year":"2015","journal-title":"Acta Otorhinolaryngol Ital"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1439-0507.2007.01416.x"},{"key":"e_1_2_6_18_1","doi-asserted-by":"crossref","first-page":"e44","DOI":"10.1097\/SCS.0000000000004010","article-title":"Bony changes in a unilateral maxillary sinus fungal ball","volume":"29","author":"Jun YJ","year":"2018","journal-title":"J Craniofac Surg"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/731640"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-6665(00)80013-4"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.27670","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.27670","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.27670","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.27670","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T16:23:07Z","timestamp":1694362987000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.27670"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,24]]},"references-count":19,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,5]]}},"alternative-id":["10.1002\/lary.27670"],"URL":"https:\/\/doi.org\/10.1002\/lary.27670","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,24]]},"assertion":[{"value":"2018-07-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}