Association between maxillary sinus fungus ball and sinus bone grafting with deproteinized bovine bone substitutes: a case-control study

ObjectiveTo evaluate the association between sinus bone graft and the development of fungus ball (FB) of the maxillary sinus.Study DesignThe 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.ResultsAll 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).ConclusionsThis 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.