Iwona Patyk

Introduction: Accurate diagnosis of peripheral pulmonary lesions is critical in suspected lung cancer, yet the optimal sampling method for subpleural lesions is unsettled. Aims and objectives: To compare virtual bronchoscopic navigation (VBN) with lung ultrasound (LUS)- and contrast-enhanced ultrasound (CEUS)-guided transthoracic biopsy in diagnostic performance and safety. Methods: Single-centre study (November 2024 to May 2026). Consecutive patients with subpleural lung lesions on CT, accessible on thoracic ultrasound, underwent LUS-, CEUS-guided biopsy, or VBN, allocated by lesion accessibility and analysed as independent groups against a final reference diagnosis. Diagnostic performance is given with exact Clopper-Pearson 95% CIs and compared by Fisher's exact test; lesion size by Kruskal-Wallis (SciPy 1.17.1, SPSS 20; two-sided p < 0.05). Results: 93 patients (LUS n=33, CEUS n=23, VBN n=37; 54% male, p=0.11). VBN had higher sensitivity (96.0%, 24/25; 95% CI 79.6-99.9) than LUS (74.2%, 23/31; p=0.03); CEUS (78.9%, 15/19) did not differ. Accuracy was 94.6% (VBN; 95% CI 81.8-99.3) vs 75.8% (LUS; p=0.04) and 82.6% (CEUS; ns). Specificity (91.7-100%) was uninformative (2-12 non-malignant/group). VBN targeted smaller lesions than LUS (median >20-30 vs >30 mm; p<0.01), i.e. harder targets. Adenocarcinoma predominated (24.7%; 78.5% malignant). Complications were rare and similar: bleeding only in VBN (3/37, 8.1%; p=0.18); pneumothorax in CEUS and VBN (n=1 each; p=0.71). Conclusions: VBN showed significantly higher sensitivity and accuracy than LUS, achieved on smaller lesions, with low, comparable complications; LUS may remain preferable for larger lesions with broad pleural contact. The study is ongoing.

Objectives: Odontogenic sinusitis (ODS) is common but frequently overlooked condition that differs from rhinogenic sinusitis (CRS) and should be suspected in each case of unilateral sinusitis. Clinical symptoms such as foul smell, congestion, rhinorrhea, and unilateral maxillary sinus opacification with overt dental pathology on radiological scans are more suggestive of ODS than CRS, but the distinctive microbiological flora are another clinical factor in diagnosis. The aim of this study was to compare the microbiological load of ODS and CRS and their clinical presentation for better disease recognition and its predisposing factors. Methods: Adult patients scheduled for endoscopic sinus surgery were included in the study. Clinical data and radiological images were analyzed. The otolaryngologist assessed nasal endoscopy for mucopurulence or edema in middle meatus or sinuses, whereas dental specialist confirmed or ruled out the dental cause. Microbiological samples were collected after endoscopic maxillary antrostomy. After irrigation with 0,9% saline, the aspirated rinse was collected into sterile sets and sent for culturing. Results: The study group consisted of 84 patients, 55 with CRS and 29 with ODS. Streptococcus spp prevailed in the CRS group, whereas Staphylococcus spp prevailed in the ODS group. Statistically significant differences between the groups were found in type of discharge, degree of edema, and presence of polyps. However, no statistical correlations were noted for presence of bacteria in the culture and endoscopic or radiological findings. Conclusions: ODS and CRS share some common features: ODS more often presents with purulent discharge, localized maxillary involvement, and the presence of oral pathogens, and Staphylococcus spp in microbial profile.