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Pesis M, Kordeluk S, Givol N. Simultaneous management of chronic maxillary sinusitis from dental origin and the relevance of nasal septal deviation: A retrospective evaluation of 65 cases. Am J Otolaryngol 2024; 45:104122. [PMID: 38035466 DOI: 10.1016/j.amjoto.2023.104122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 11/19/2023] [Indexed: 12/02/2023]
Abstract
PURPOSE Dental origin constitutes most chronic unilateral maxillary sinusitis (CMS) and is referred to as dental chronic maxillary sinusitis (DCMS). Recently, dental implants and related surgical procedures have become more prevalent. We present an evaluation of the simultaneous treatment of DCMS. MATERIALS AND METHODS A retrospective review of records from 395 patients with CMS treated at our medical center from 2015 to 2020 found 65 patients diagnosed with DCMS. Statistical analyses were performed using the records data. RESULTS Four patients were excluded. The final study population included 35 males and 26 females with a mean age of 55. 29 % were post-dental implant placement or related pre-prosthetic procedures. Presenting symptoms included middle meatus edema (72 %), pus in the middle meatus (70 %), and nasal secretion (39 %). Clinical findings included septal deviation (39 %), among them 87 % deviated toward the diseased sinus, OAF (49 %), and nasal polyposis (16 %). In 32 patients, the OAF was closed in one layer using a local mucoperiosteal flap. In 29 patients, the closure was done in two layers, including a buccal fat pad (BFP) regional flap. One patient had a reopened OAF, and five patients required revision surgery. 92 % of patients in this study had complete clinical and radiological resolution of the DCMS. CONCLUSIONS Relevance of nasal septal deviation in association with DCMS is present. There is no distinct difference in the manner of OAF closure if it is done in a simultaneous procedure. One stage combined multidisciplinary surgical procedure is sufficient to treat DCMS.
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Affiliation(s)
- Michael Pesis
- Oral and Maxillofacial Surgery Unit, Soroka University Medical Center, Beer Sheva, Israel; The Faculty of Health Sciences, Ben Gurion University, Beer Sheva, Israel.
| | - Sofia Kordeluk
- Department of Otolaryngology-Head and Neck Surgery, Soroka University Medical Center, Beer Sheva, Israel; The Faculty of Health Sciences, Ben Gurion University, Beer Sheva, Israel
| | - Navot Givol
- Oral and Maxillofacial Surgery Unit, Soroka University Medical Center, Beer Sheva, Israel; The Faculty of Health Sciences, Ben Gurion University, Beer Sheva, Israel
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Safadi A, Kleinman S, Gigi D, Wengier A, Oz I, Abergel A, Koren I, Ungar OJ. Surgical management of odontogenic cysts involving the maxillary sinus- a retrospective study. J Craniomaxillofac Surg 2020; 48:800-807. [PMID: 32682620 DOI: 10.1016/j.jcms.2020.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 04/11/2020] [Accepted: 06/23/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To describe our strategy for the management of odontogenic cysts involving the maxillary sinus, and to define the role of transnasal endoscopic sinus surgery in the treatment algorithm. METHODS A retrospective study was conducted. Included were all consecutive patients with odontogenic cysts involving the maxillary sinus who were treated in a single medical center between 2011 and 2019. Their medical records were reviewed for demographic data, preoperative presentation, surgical approach, final pathology, and postoperative course. Odontogenic cysts were classified as small or large according to maxillary sinus extension within or beyond the alveolar recess, respectively. RESULTS A total of 30 patients with odontogenic cysts involving the maxillary sinus were treated by a team of maxillofacial and endoscopic sinus surgeons during the study period. There were 11 cases of dentigerous cysts, 11 radicular cysts, seven odontogenic keratocysts (OKCs), and one glandular cyst. Sixteen cases were managed by transnasal endoscopic sinus surgery alone and 14 were managed by a combined intraoral and endoscopic sinus surgery approach. A total of 22 patients had large cysts and total resection was achieved in 20 of them. There was one case of OKC recurrence during an average follow-up of 31 months. No major complications were recorded. CONCLUSIONS The endoscopic approach can serve as an alternative to the transalveolar or lateral window approach. The endoscopic approach is associated with low morbidity and low recurrence rates.
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Affiliation(s)
- Ahmad Safadi
- Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sackler School of Medicine. Tel-Aviv University, Tel-Aviv, Israel.
| | - Shlomi Kleinman
- Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sackler School of Medicine. Tel-Aviv University, Tel-Aviv, Israel
| | - Dana Gigi
- Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sackler School of Medicine. Tel-Aviv University, Tel-Aviv, Israel
| | - Anat Wengier
- Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sackler School of Medicine. Tel-Aviv University, Tel-Aviv, Israel
| | - Itay Oz
- Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sackler School of Medicine. Tel-Aviv University, Tel-Aviv, Israel
| | - Avraham Abergel
- Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sackler School of Medicine. Tel-Aviv University, Tel-Aviv, Israel
| | - Ilan Koren
- Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sackler School of Medicine. Tel-Aviv University, Tel-Aviv, Israel
| | - Omer J Ungar
- Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sackler School of Medicine. Tel-Aviv University, Tel-Aviv, Israel
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Sella A, Ben-Zvi Y, Gillman L, Avishai G, Chaushu G, Rosenfeld E. Evaluation of Surgical Treatment of Oroantral Fistulae in Smokers Versus Non-Smokers. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E310. [PMID: 32585934 PMCID: PMC7353848 DOI: 10.3390/medicina56060310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/16/2020] [Accepted: 06/19/2020] [Indexed: 12/15/2022]
Abstract
Background and Objectives: Smoking has been found to interfere with wound healing processes. Therefore, the purpose of this study was to compare surgical treatment of oroantral fistulae (OAFs) in smokers and non-smokers. Materials and Methods: Medical records of all consecutive patients who underwent surgical closure of OAFs between 2003 and 2016 at the oral and maxillofacial surgery department, Rabin Medical Center, Israel were reviewed. Patients' demographic data, preoperative signs and symptoms, surgical method of repair, and postoperative complications were recorded. Results: The cohort consisted of 38 smokers and 59 non-smokers. Age and gender distributions were similar in both groups. The main etiology in both groups was tooth extraction, followed by pre-prosthetic surgery in smokers and odontogenic infection in non-smokers (p = 0.02). Preoperative conditions were not significantly different between smokers and non-smokers in terms of size of soft tissue fistula and bony defect, chronic sinusitis and foreign bodies inside the sinus. OAFs were repaired by local soft tissue flaps without consideration of smoking status. Smokers experienced more moderate-severe postoperative pain (p = 0.05) and requested more weak opioids (p = 0.06). Postoperative complications included infection, delayed wound healing, residual OAF, pain, sensory disturbances and sino nasal symptoms. These were mostly minor and tended to be more frequent in smokers (p = 0.35). Successful closure of OAFs was obtained in all patients except one smoker who required revision surgery. Conclusions: Smokers may be more susceptible to OAFs secondary to preprosthetic surgery. In this cohort, there was no statistically significant difference in outcome between smokers and non-smokers in terms of failure. However, smokers tended to have more severe postoperative pain and discomfort and to experience more postoperative complications. Further studies with larger sample sizes should be conducted to validate these results.
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Affiliation(s)
- Adi Sella
- Oral and Maxillofacial Surgery Unit, Shaare Zedek Medical Center, P.O.B 3235, 9103102 Jerusalem, Israel
| | - Yehonatan Ben-Zvi
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center, Beilinson Campus, 49100 Petach-Tikva, Israel; (Y.B.-Z.); (L.G.); (G.A.); (G.C.); (E.R.)
| | - Leon Gillman
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center, Beilinson Campus, 49100 Petach-Tikva, Israel; (Y.B.-Z.); (L.G.); (G.A.); (G.C.); (E.R.)
| | - Gal Avishai
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center, Beilinson Campus, 49100 Petach-Tikva, Israel; (Y.B.-Z.); (L.G.); (G.A.); (G.C.); (E.R.)
| | - Gavriel Chaushu
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center, Beilinson Campus, 49100 Petach-Tikva, Israel; (Y.B.-Z.); (L.G.); (G.A.); (G.C.); (E.R.)
| | - Eli Rosenfeld
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center, Beilinson Campus, 49100 Petach-Tikva, Israel; (Y.B.-Z.); (L.G.); (G.A.); (G.C.); (E.R.)
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Xia J, Ma Y, Tian H, Zhang R. Repair of oroantral fistula via modified endoscopic medial maxillectomy with free nasal mucoperichondrial-osteal graft. Acta Otolaryngol 2019; 139:701-706. [PMID: 31107127 DOI: 10.1080/00016489.2019.1614221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Many techniques have been proposed to close an oroantral fistula (OAF), with most of them involving transoral repairs with oral soft tissue flaps. An additional Caldwell-Luc approach or endoscopic sinus surgery (ESS) is required to address coexisting maxillary sinusitis. Objectives: This study presents the endonasal closure of an OAF through modified endoscopic medial maxillectomy (MEMM) with a free nasal mucoperichondrial-osteal graft. Materials and methods: Sixteen OAF patients who underwent closure operations in our department from May 2013 to June 2018 were retrospectively reviewed. Results: The main cause of OAF was maxillary dental cysts (56.25%). The OAF size ranged from 2 × 2 to 10 × 15 mm. The first molar (62.5%) was the most frequently involved tooth. All closures were made via MEMM, using nasal mucoperichondrial-osteal grafts harvested from the septum or nasal base. All patients were followed up for at least six months. Successful closure after a single procedure was achieved in 93.75% of cases. No obvious complications or recurrences were observed. Conclusions: Endonasal repair of OAFs via MEMM with free nasal mucosal grafts is feasible and promising. The approach preserves the normal oral and nasal physiology after surgery. It could be used alone for the closure of small to medium-sized OAFs.
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Affiliation(s)
- Jiao Xia
- Otorhinolaryngology – Head and Neck Surgery Department, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
| | - Youxiang Ma
- Otorhinolaryngology – Head and Neck Surgery Department, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
| | - Hao Tian
- Otorhinolaryngology – Head and Neck Surgery Department, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
| | - Ruxiang Zhang
- Otorhinolaryngology – Head and Neck Surgery Department, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
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Combined endoscopic and intra-oral approach for chronic maxillary sinusitis of dental origin-a prospective clinical study. Oral Maxillofac Surg 2019; 23:429-437. [PMID: 31332583 DOI: 10.1007/s10006-019-00792-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 07/10/2019] [Indexed: 12/16/2022]
Abstract
AIMS AND OBJECTIVES The traditional Caldwell-Luc approach for maxillary diseases has been criticized for its shortcomings such as removal of a large amount of bone, numbness of the teeth, flap dehiscence, and recurrent sinusitis. On account of its minimal invasiveness and physiological approach, functional endoscopic sinus surgery (FESS) has come to replace the Caldwell-Luc approach for the treatment of chronic rhinosinusitis. Chronic maxillary sinusitis of dental origin (CMSDO) is a less common variant on the chronic rhinosinusitis spectrum whose treatment involves simultaneous management of both the diseased maxillary sinus and the dental source of infection. Thus, this study was undertaken to assess the efficacy of FESS when combined with an intra-oral approach for the treatment of CMSDO. MATERIAL AND METHODS Eighteen patients with CMSDO in the age group of 18-50 years were treated with a combined endoscopic and intra-oral approach (buccal advancement flap with/without buccal fat pad) in this study. The patients were followed up for a total duration of 18 months. The primary outcome measurements were the SNOT-22 Quality of Life questionnaire and the Lund and Mackay CT Scan Scoring Criteria. The Friedman test was used to assess improvement in the above variables and the level of significance was set at 0.05. OBSERVATIONS AND RESULTS There was a statistically significant reduction (p < 0.05) in both the above parameters at all post-operative intervals. Two patients presented with epistaxis (immediate post-operative phase) and synechiae (second week follow-up interval). Both complications were successfully resolved. Two patients showed recurrence at the 6th-month interval for which they underwent revision surgery successfully. Overall, results were maintained even at the 18th month follow-up interval. CONCLUSION The endoscopic approach appears to be a reliable, minimally invasive technique associated with less morbidity and stable long-term results. Thus, a multi-disciplinary approach between maxillofacial surgeons and otolaryngologists is essential in the treatment of CMSDO.
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Durnovo EA, Fedorichev AO, Homutinnikova NE. [Modern view on the problem of oroantral fistula closure: literature review]. STOMATOLOGII︠A︡ 2019; 98:76-80. [PMID: 31089126 DOI: 10.17116/stomat20199802176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article includes a review of Russian and foreign literature concerning the current situation in problem of oroantral fistula closure. This review considers main concepts and methods of plastic surgery directed to reconstruct tightness of mouth. Moreover, the advantages and disadvantages of presented methods among themselves and appreciated long-term results and aftermath of different ways of surgical technics.
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Affiliation(s)
- E A Durnovo
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - A O Fedorichev
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia
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Kim SM. Definition and management of odontogenic maxillary sinusitis. Maxillofac Plast Reconstr Surg 2019; 41:13. [PMID: 30989083 PMCID: PMC6439010 DOI: 10.1186/s40902-019-0196-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 02/22/2019] [Indexed: 02/07/2023] Open
Abstract
Background Maxillary sinusitis of odontogenic origin, also known as maxillary sinusitis of dental origin or odontogenic maxillary sinusitis (OMS), is a common disease in dental, otorhinolaryngologic, allergic, general, and maxillofacial contexts. Despite being a well-known disease entity, many cases are referred to otorhinolaryngologists by both doctors and dentists. Thus, early detection and initial diagnosis often fail to detect its odontogenic origin. Main body We searched recent databases including MEDLINE (PubMed), Embase, and the Cochrane Library using keyword combinations of "odontogenic," "odontogenic infection," "dental origin," "tooth origin," "sinusitis," "maxillary sinus," "maxillary sinusitis," "odontogenic maxillary sinusitis," "Caldwell Luc Procedure (CLP)," "rhinosinusitis," "functional endoscopic sinus surgery (FESS)," "modified endoscopy-assisted maxillary sinus surgery (MESS)," and "paranasal sinus." Aside from the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) trial, there have been very few randomized controlled trials examining OMS. We summarized the resulting data based on our diverse clinical experiences. Conclusion To promote the most efficient and accurate management of OMS, this article summarizes the clinical features of rhinosinusitis compared with OMS and the pathogenesis, microbiology, diagnosis, and results of prompt consolidated management of OMS that prevent anticipated complications. The true origin of odontogenic infections is also reviewed.
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Affiliation(s)
- Soung Min Kim
- Oral and Maxillofacial Microvascular Reconstruction LAB, Ghana Health Service, Brong Ahafo Regional Hospital, P.O. Box 27, Sunyani, Brong Ahafo Ghana.,2Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 110-768 South Korea
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Mannelli G, Arcuri F, Comini L, Valente D, Spinelli G. Buccal Fat Pad: Report of 24 Cases and Literature Review of 1,635 Cases of Oral Defect Reconstruction. ORL J Otorhinolaryngol Relat Spec 2018; 81:24-35. [DOI: 10.1159/000494027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 09/25/2018] [Indexed: 11/19/2022]
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