{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:40:43Z","timestamp":1787841643599,"version":"build-2784847793"},"reference-count":46,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100032748","name":"St. Martin De Porres Hospital","doi-asserted-by":"publisher","award":["STM\u2010H101\u2010P001"],"award-info":[{"award-number":["STM\u2010H101\u2010P001"]}],"id":[{"id":"10.13039\/100032748","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective(s)<\/jats:title>\n                    <jats:p>Fungus ball (FB) is a unilateral form of fungal rhinosinusitis, but it remains unclear whether associated microbial dysbiosis is restricted to the lesional sinus or extends across the sinonasal cavity. This study aimed to determine whether bacterial and fungal dysbiosis in maxillary sinus FB is spatially localized by comparing paired lesional and contralateral\u2010normal sites within the same individuals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective paired\u2010sample study enrolled 14 adults with surgically confirmed unilateral maxillary sinus FB at a tertiary referral center. Middle\u2010meatal swabs were obtained from lesional and contralateral\u2010normal sides during endoscopic sinus surgery. Bacterial and fungal communities were profiled using 16S rRNA gene and internal transcribed spacer (ITS) sequencing. Alpha and beta diversity, taxonomic composition, predicted functional pathways, and bacterial\u2013fungal co\u2010occurrence networks were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Lesional sinuses showed significantly reduced bacterial alpha diversity compared with contralateral\u2010normal sides (Wilcoxon\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and distinct bacterial beta diversity (PERMANOVA\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). Fungal beta diversity also differed between sites (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), whereas fungal alpha diversity was preserved. Lesional communities showed enrichment of anaerobic and pathobiont taxa, including\n                      <jats:italic>Haemophilus<\/jats:italic>\n                      ,\n                      <jats:italic>Enterococcus<\/jats:italic>\n                      , and\n                      <jats:italic>Pseudomonas<\/jats:italic>\n                      , with reduced relative abundance of\n                      <jats:italic>Staphylococcus<\/jats:italic>\n                      . Although\n                      <jats:italic>Aspergillus<\/jats:italic>\n                      abundance was similar bilaterally, network analysis suggested altered\n                      <jats:italic>Aspergillus<\/jats:italic>\n                      \u2010associated connectivity in lesional samples, consistent with a shift in inferred interaction topology rather than increased\n                      <jats:italic>Aspergillus<\/jats:italic>\n                      abundance. Predicted functional analysis further suggested pathway differences that may reflect altered local metabolic conditions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      In this cohort, microbial dysbiosis in maxillary sinus FB appeared to be spatially localized, with patterns suggestive of anaerobe enrichment and ecological reorganization centered on\n                      <jats:italic>Aspergillus<\/jats:italic>\n                      . These findings are compatible with the standard surgical emphasis on fungal mass removal and restoration of sinus drainage\/aeration, but the microbiome\u2010based relevance of aeration requires confirmation in larger studies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lio2.70534","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T09:01:24Z","timestamp":1786957284000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Microbiota and Mycobiota Dysbiosis in Sinonasal Fungus Ball: A Paired Lesional and Contralateral Analysis"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7034-4149","authenticated-orcid":false,"given":"Yen\u2010Ting","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Otolaryngology St. Martin De Porres Hospital  Chiayi Taiwan"},{"name":"Department of Otolaryngology Chung Shan Medical University Hospital  Taichung Taiwan"},{"name":"School of Medicine Chung Shan Medical University  Taichung Taiwan"},{"name":"Institute of Medicine Chung Shan Medical University  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5690-4194","authenticated-orcid":false,"given":"Cheng\u2010Yang","family":"Lee","sequence":"additional","affiliation":[{"name":"Graduate Institute of Biomedical Informatics, College of Medical Science and Technology Taipei Medical University  Taipei City Taiwan"},{"name":"Bioinformatics Center, Office of Data Science Taipei Medical University  Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shao\u2010Hung","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Biopharmaceuticals National Chiayi University  Chiayi Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung\u2010Han","family":"Hsin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Chung Shan Medical University Hospital  Taichung Taiwan"},{"name":"School of Medicine Chung Shan Medical University  Taichung Taiwan"},{"name":"Institute of Medicine Chung Shan Medical University  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Xuan","family":"Li","sequence":"additional","affiliation":[{"name":"Bioinformatics Center, Office of Data Science Taipei Medical University  Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying\u2010Chou","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology St. Martin De Porres Hospital  Chiayi Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun\u2010Fa","family":"Yang","sequence":"additional","affiliation":[{"name":"Institute of Medicine Chung Shan Medical University  Taichung Taiwan"},{"name":"Department of Medical Research Chung Shan Medical University Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yih\u2010Yuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Biochemical Science and Technology National Chiayi University  Chiayi Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzu\u2010Hao","family":"Chang","sequence":"additional","affiliation":[{"name":"Graduate Institute of Biomedical Informatics, College of Medical Science and Technology 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