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Kwiatkowska MA, Craig JR. Unilateral Sinus Disease: What Is, and Is Not Odontogenic Sinusitis? Otolaryngol Clin North Am 2024:S0030-6665(24)00090-2. [PMID: 39147657 DOI: 10.1016/j.otc.2024.06.005] [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: 08/17/2024]
Abstract
The differential diagnosis of unilateral sinus disease (USD) is broad, and while concerning etiologies like sinonasal neoplasia, invasive fungal sinusitis, and cerebrospinal fluid rhinorrhea should always be considered, most cases are due to noninvasive inflammatory or infectious conditions. To diagnose USD appropriately, clinicians must integrate the clinical history and examination, nasal endoscopy, computed tomography (CT), and possibly MRI. Odontogenic sinusitis (ODS) is the most common cause of unilateral maxillary sinus opacification on CT, with 45% to 75% of such cases being odontogenic in nature. This study provides USD diagnostic considerations and reinforces the diagnostic approach to ODS.
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Affiliation(s)
- Marta A Kwiatkowska
- Department of Otolaryngology and Oncological Laryngology, Military Institute of Medicine, National Research Institute, Warsaw, Poland. https://twitter.com/MartaKwiat_ska
| | - John R Craig
- Division Head of Rhinology, Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health-Michigan State University College of Human Medicine, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA.
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2
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Tröltzsch M. Epidemiology of Odontogenic Sinusitis. Otolaryngol Clin North Am 2024:S0030-6665(24)00098-7. [PMID: 39142997 DOI: 10.1016/j.otc.2024.07.001] [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: 08/16/2024]
Abstract
Odontogenic sinusitis (ODS) is more common than historically thought, representing 25% to 40% of all maxillary sinusitis. Due to a lack of widely accepted diagnostic criteria and a specific international diagnostic code, a true overall prevalence is unknown. ODS may be caused by either a multitude of infectious dental pathologies or complications after dental procedures. The most common dental etiologies causing ODS are apical periodontitis (endodontic) and oroantral communication or fistula after dental extraction. Less commonly, ODS can evolve after dental implant or maxillary sinus bone grafting surgeries, infection of odontogenic cysts, or advanced periodontitis.
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Affiliation(s)
- Matthias Tröltzsch
- Center for Oral, Maxillofacial and Facial Reconstructive Surgery, Maximilianstraße 5, Ansbach 91522, Germany; Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital LMU, Lindwurmstraße 2a, Munich 80336, Germany.
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3
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Boeddinghaus R, Ratcliffe M. Imaging of Odontogenic Sinusitis. Otolaryngol Clin North Am 2024:S0030-6665(24)00095-1. [PMID: 39089984 DOI: 10.1016/j.otc.2024.06.010] [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: 08/04/2024]
Abstract
Odontogenic sinusitis (ODS) has been shown to be the most common cause of unilateral maxillary sinus opacification on computed tomography scans. Review of the maxillary alveolar ridge and maxillary tooth roots, and their relationships to the maxillary sinus floor is essential when interpreting paranasal sinus imaging. In recent years, ODS has received increased attention in the recent otolaryngologic and dental literature. This article will discuss technical considerations to optimize imaging of the paranasal sinuses and maxillary dentition, as well as both classic and nuanced radiologic findings of ODS.
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Affiliation(s)
- Rudolf Boeddinghaus
- Perth Radiological Clinic, 127 Hamersley Road, Subiaco, Western Australia 6008, Australia; Department of Surgery, University of Western Australia, Nedlands, Western Australia 6009, Australia.
| | - Michael Ratcliffe
- Perth Radiological Clinic, 127 Hamersley Road, Subiaco, Western Australia 6008, Australia
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Yu AJ, Espinosa M, Adappa ND, Douglas JE. Complicated Odontogenic Sinusitis: Extrasinus Infectious Spread. Otolaryngol Clin North Am 2024:S0030-6665(24)00088-4. [PMID: 39048507 DOI: 10.1016/j.otc.2024.06.003] [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: 07/27/2024]
Abstract
Odontogenic sinusitis (ODS) is a common cause of orbital, intracranial, and osseous infectious extrasinus complications. Dental infections can spread to the orbital or intracranial spaces though the sinuses via thrombophlebitis or direct extension, or from the dentition or oral cavity via vascular channels in the maxillary alveolar bone. ODS typically presents with unilateral involvement both clinically and radiographically. Any suspicion for extrasinus spread based on history and physical examination should be followed by appropriate imaging, formal dental evaluation, and, when appropriate, ophthalmology and neurosurgery consultations. This multidisciplinary approach ensures appropriate management of both the acute orbital and intracranial complications.
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Affiliation(s)
- Alison J Yu
- Caruso Department of Otolaryngology-Head and Neck Surgery, University of Southern California, 1537 Norfolk Street, Suite 5800, Los Angeles, CA 90033, USA
| | - Maria Espinosa
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, 1977 Butler Boulevard Suite E5.200, Houston, TX 77030, USA
| | - Nithin D Adappa
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, 3400 Spruce Street, 5 Ravdin, Philadelphia, PA 19104, USA
| | - Jennifer E Douglas
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, 3400 Spruce Street, 5 Ravdin, Philadelphia, PA 19104, USA.
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Safadi A, Saibene AM, Craig JR. Sinus Evaluation for Odontogenic Sinusitis. Otolaryngol Clin North Am 2024:S0030-6665(24)00087-2. [PMID: 39048505 DOI: 10.1016/j.otc.2024.06.002] [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: 07/27/2024]
Abstract
This article summarizes how to diagnose common and nuanced cases of odontogenic sinusitis (ODS) through a collaborative approach between otolaryngologists and dental specialists, with a heightened focus on the role of otolaryngologists in the diagnostic process. A critical part of the diagnostic framework is that otolaryngologists must confirm the infectious sinusitis but also suspect ODS to ensure he or she refers the patient to a dental specialist to confirm or refute ipsilateral infectious maxillary dental pathology. To confirm the purulent sinusitis of ODS, nasal endoscopy is most critical. Computed tomography imaging is an important part of the workup.
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Affiliation(s)
- Ahmad Safadi
- Otolaryngology-Head and Neck Surgery Unit, Tzafon Medical Center, Affiliated with Azrieli Faculty of Medicine, Bar Ilan University, Poriya M.P. The Lower Galilee 15208, Israel
| | - Alberto Maria Saibene
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Via Antonio di Rudinì, 8, Milan 20142, Italy; Department of Health Sciences, Università Degli Studi di Milano, Via Antonio Di Rudinì 8, Milan, Italy.
| | - John R Craig
- Department of Otolaryngology-Head and Neck Surgery, Henry Ford Hospital, Henry Ford Health, 2799 West Grand Boulevard, Detroit, MI 48202, USA. https://twitter.com/JohnCraigNose
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Rosso C, Urbanelli A, Spoldi C, Felisati G, Pecorari G, Pipolo C, Nava N, Saibene AM. Pediatric Odontogenic Sinusitis: A Systematic Review. J Clin Med 2024; 13:2215. [PMID: 38673488 PMCID: PMC11050471 DOI: 10.3390/jcm13082215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 03/26/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Pediatric odontogenic sinusitis (PODS) is a rare condition with limited research on its clinical features, diagnostic criteria, and treatment options. The current guidelines on pediatric rhinosinusitis do not mention a possible dental origin of the disease. This systematic review aims to summarize and analyze the existing literature on PODS, focusing on epidemiology, etiology, diagnostic tools, complications, treatment options, and outcomes. Methods: A systematic review was conducted following PRISMA reporting guidelines. Electronic searches were performed in multiple databases using keywords related to PODS and therapeutic strategies. Original articles reporting data on treatment outcomes for PODS were included. Results: The review highlighted the scarcity of high-quality evidence on PODS. The literature mainly consists of case reports and low-grade evidence studies. Limited data on the epidemiology, etiology, diagnostic tools, complications, and treatment outcomes of PODS in children are available. Conclusions: Further research is needed to better understand the clinical features, diagnosis, and treatment of PODS in pediatric patients. High-quality studies are required to establish evidence-based guidelines for the management of this condition, especially given the apparently high rate of complications when compared to adult ODS.
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Affiliation(s)
- Cecilia Rosso
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, 20142 Milan, Italy; (C.R.); (C.S.); (G.F.); (C.P.); (N.N.)
| | - Anastasia Urbanelli
- Otorhinolaryngology Unit, Department of Surgical Sciences, University of Turin, 10124 Turin, Italy; (A.U.); (G.P.)
| | - Chiara Spoldi
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, 20142 Milan, Italy; (C.R.); (C.S.); (G.F.); (C.P.); (N.N.)
| | - Giovanni Felisati
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, 20142 Milan, Italy; (C.R.); (C.S.); (G.F.); (C.P.); (N.N.)
| | - Giancarlo Pecorari
- Otorhinolaryngology Unit, Department of Surgical Sciences, University of Turin, 10124 Turin, Italy; (A.U.); (G.P.)
| | - Carlotta Pipolo
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, 20142 Milan, Italy; (C.R.); (C.S.); (G.F.); (C.P.); (N.N.)
| | - Nicolò Nava
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, 20142 Milan, Italy; (C.R.); (C.S.); (G.F.); (C.P.); (N.N.)
| | - Alberto Maria Saibene
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, 20142 Milan, Italy; (C.R.); (C.S.); (G.F.); (C.P.); (N.N.)
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Lin J, Wang C, Wang X, Chen F, Zhang W, Sun H, Yan F, Pan Y, Zhu D, Yang Q, Ge S, Sun Y, Wang K, Zhang Y, Xian M, Zheng M, Mo A, Xu X, Wang H, Zhou X, Zhang L. Expert consensus on odontogenic maxillary sinusitis multi-disciplinary treatment. Int J Oral Sci 2024; 16:11. [PMID: 38302479 PMCID: PMC10834456 DOI: 10.1038/s41368-024-00278-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/25/2023] [Accepted: 01/02/2024] [Indexed: 02/03/2024] Open
Abstract
ABSTARCT Odontogenic maxillary sinusitis (OMS) is a subtype of maxillary sinusitis (MS). It is actually inflammation of the maxillary sinus that secondary to adjacent infectious maxillary dental lesion. Due to the lack of unique clinical features, OMS is difficult to distinguish from other types of rhinosinusitis. Besides, the characteristic infectious pathogeny of OMS makes it is resistant to conventional therapies of rhinosinusitis. Its current diagnosis and treatment are thus facing great difficulties. The multi-disciplinary cooperation between otolaryngologists and dentists is absolutely urgent to settle these questions and to acquire standardized diagnostic and treatment regimen for OMS. However, this disease has actually received little attention and has been underrepresented by relatively low publication volume and quality. Based on systematically reviewed literature and practical experiences of expert members, our consensus focuses on characteristics, symptoms, classification and diagnosis of OMS, and further put forward multi-disciplinary treatment decisions for OMS, as well as the common treatment complications and relative managements. This consensus aims to increase attention to OMS, and optimize the clinical diagnosis and decision-making of OMS, which finally provides evidence-based options for OMS clinical management.
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Affiliation(s)
- Jiang Lin
- Department of Stomatology, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Chengshuo Wang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Xiangdong Wang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Faming Chen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shanxi International Joint Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, The Fourth Military Medical University, Xi' an, China
| | - Wei Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, Beijing, China
| | - Hongchen Sun
- Department of Oral &Maxillofacial Pathology, School and Hospital of Stomatology, Jilin University, Jilin, China
| | - Fuhua Yan
- Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yaping Pan
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Dongdong Zhu
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Qintai Yang
- Department of Otolaryngology, Head and Neck Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shaohua Ge
- Department of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration, Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration, Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
| | - Yao Sun
- Department of Implantology, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Kuiji Wang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Yuan Zhang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Mu Xian
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China
- Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Ming Zheng
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Anchun Mo
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Xu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hanguo Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Oral Diseases, Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Luo Zhang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China.
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
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Wu J, Zheng M, Wang X, Wang S. Endo-Periodontal Lesions-An Overlooked Etiology of Odontogenic Sinusitis. J Clin Med 2023; 12:6888. [PMID: 37959353 PMCID: PMC10648035 DOI: 10.3390/jcm12216888] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 10/24/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
The aim of this study was to analyze the oral etiology of patients with odontogenic sinusitis (ODS) and to compare the differences in demographic data, clinical symptoms, extent of sinus involvement, bone penetration of the maxillary sinus floor (MSF) between different etiologies. A retrospective investigation was conducted on 103 patients with ODS recruited from Beijing TongRen Hospital. All enrolled patients underwent sinus CT, nasal endoscopy, and oral examination. A comparison of the patients' clinical symptoms, the extent of involvement of the sinuses, and bone resorption of the MSF according to odontogenic etiologies was conducted. Follow-up was based on symptoms and clinical examination. The most common odontogenic etiologies were endo-periodontal lesions (EPLs, 49.5%), apical periodontitis (AP, 32.0%), and periodontitis (PE, 8.7%). There were statistically significant differences in age (p = 0.002), sex (p = 0.036), inflammation involving the ethmoid sinus (p = 0.037), and bone penetration of the MSF (p < 0.001) between the AP, EPL, and PE groups. There were no significant differences in sinusitis symptoms (p > 0.005) among patients with different odontogenic etiologies. In conclusion, EPL is a neglected oral etiology with a destructive effect on the bone of the MSF, which deserves more attention in diagnosis and treatment.
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Affiliation(s)
- Jianyou Wu
- Beijing Stomatological Hospital, Capital Medical University, Tian Tan Xi Li 4#, Beijing 100050, China;
- Beijing Laboratory of Oral Health, Capital Medical University, Tian Tan Xi Li 4#, Beijing 100050, China
- Department of Stomatology, Beijing TongRen Hospital, Capital Medical University, Dongjiaominxiang, Beijing 100730, China
| | - Ming Zheng
- Department of Otolaryngology–Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Dongjiaominxiang, Beijing 100730, China;
| | - Xiangdong Wang
- Department of Otolaryngology–Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Dongjiaominxiang, Beijing 100730, China;
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otorhinolaryngology, Dongjiaominxiang, Beijing 100730, China
| | - Songlin Wang
- Beijing Laboratory of Oral Health, Capital Medical University, Tian Tan Xi Li 4#, Beijing 100050, China
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Zhang L, Zhang Y, Xu Q, Shu J, Xu B, Liu L, Chen H, Hu Y, Li Y, Song L. Increased risks of maxillary sinus mucosal thickening in Chinese patients with periapical lesions. Heliyon 2023; 9:e18050. [PMID: 37519707 PMCID: PMC10372233 DOI: 10.1016/j.heliyon.2023.e18050] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 07/02/2023] [Accepted: 07/05/2023] [Indexed: 08/01/2023] Open
Abstract
Objectives This study aimed to evaluate the effects of factors related to periapical lesions (PALs) on sinus membrane thickening (SMT) in the Chinese population using cone-beam computed tomography (CBCT). Methods In this retrospective study, CBCT images (n = 512) of maxillary sinuses of 446 patients were evaluated by two examiners for SMT and PALs, PAL size, and the distance between the maxillary sinus floor (MSF), and the PAL's edge/root apex. The data were analyzed using analysis of variance, the Kruskal-Wallis test, χ2-test, and logistic regression. Results A binary logistic regression model showed that the prevalence and severity of SMT > 2 mm were significantly associated with older age (>60 years) (odds ratio [OR]: 4.03, 95% confidence interval [CI]): 2.24-7.72, P < 0.001], male sex (OR: 2.08, 95% CI: 1.21-3.56, P < 0.006), and PALs (OR: 6.89, 95% CI: 3.93-12.08, P < 0.001). The type of contact and penetration between the MSF and PALs or root apex showed a more significant relation with SMT > 2 mm than did distance after adjusting for confounding factors, including age and sex (PALs: OR = 10.17 and 14.57, P < 0.001; root apex: OR = 3.49 and 5.86, P < 0.001). Conclusions The prevalence and severity of SMT were significantly associated with older age, male sex, PALs, PAL size, and the distance between the MSF and PALs/root apex. Therefore, communication between dental surgeons and an otolaryngology specialist is important for the timely diagnosis and treatment of SMT of dental origin.
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Affiliation(s)
- Limin Zhang
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Yanan Zhang
- Department of Stomatology, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan 250001, China
| | - Qimei Xu
- School of Stomatology, Bengbu Medical College, Bengbu, Anhui 233000, China
| | - Jingjing Shu
- Department of Periodontology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Bin Xu
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Liuhui Liu
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Huijuan Chen
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Yue Hu
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Yinghua Li
- Clinical Laboratory, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Liang Song
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
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Vitali FC, Santos PS, Massignan C, Maia LC, Cardoso M, Teixeira CDS. Global Prevalence of Maxillary Sinusitis of Odontogenic Origin and Associated Factors: A Systematic Review and Meta-Analysis. J Endod 2023; 49:369-381.e11. [PMID: 36754253 DOI: 10.1016/j.joen.2023.01.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/26/2023] [Accepted: 01/28/2023] [Indexed: 02/08/2023]
Abstract
INTRODUCTION The overall prevalence of maxillary sinusitis of odontogenic origin (MSOO) is still unknown. Therefore, this study aimed to determine the pooled prevalence of MSOO and verify associations between different odontogenic conditions and MSOO. METHODS Six electronic databases and the gray literature were searched on August 25, 2022. Two independent reviewers selected observational studies reporting the prevalence of MSOO and associated conditions in adults. Studies that did not use computed tomography for diagnosis were excluded. The methodological quality of the studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Cross-Sectional Studies. Data were analyzed by proportion and association meta-analyses. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS Thirty-eight studies were included in the qualitative analysis and thirty-one in the meta-analyses. Only 12 studies (31.6%) fulfilled all items of the methodological quality checklist. Overall, the studies reported prevalence measures per maxillary sinus or patient. Thus, the pooled prevalence of MSOO was 51% per sinus (95% confidence interval [CI] [40%-61%]) and 50% per patient (95% CI [41%-59%]). Apical lesion (odds ratio [OR]: 4.03, 95% CI [2.26-7.19]), periodontitis (OR: 5.49, 95% CI [2.27-13.24]), moderate (OR: 2.57, 95% CI [1.85-3.57]) and severe bone loss (OR: 13.80, 95% CI [2.81-67.85] were significantly associated with MSOO. The certainty of the evidence for the associations was very low. CONCLUSIONS The pooled prevalence of MSOO on computed tomography assessment was 51% per maxillary sinus and 50% per patient. Therefore, half of the maxillary sinusitis may be of odontogenic origin. Apical lesion, periodontitis, and moderate and severe bone loss were significantly associated with MSOO.
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Affiliation(s)
- Filipe Colombo Vitali
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil.
| | - Pablo Silveira Santos
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Carla Massignan
- Department of Dentistry, University of Brasilia, Brasilia, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mariane Cardoso
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil
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Chung SY, Halderman AA. Tips and tricks for management of the dysfunctional maxillary sinus. Curr Opin Otolaryngol Head Neck Surg 2023; 31:24-32. [PMID: 36484283 DOI: 10.1097/moo.0000000000000860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW To review the various factors associated with the most common cause of maxillary sinus dysfunction; recalcitrant chronic maxillary sinusitis (RCMS). In addition, available medical and surgical management options are discussed along with various tips and tricks for optimal management. RECENT FINDINGS Defects in mucociliary clearance, immunodeficiency, anatomic factors, and infectious etiologies have been implicated in dysfunction of the maxillary sinus leading to RCMS. Medical management including oral antibiotics or topical drugs have shown varying degrees of success. Endoscopic modified medial maxillectomy (EMMM) has been shown to significantly improve symptoms in patients with RCMS. SUMMARY A dysfunctional maxillary sinus presents a clinical challenge. A thorough evaluation of any potential contributing factors must be done in addition to an assessment of the adequacy of prior surgical treatment of the maxillary sinus. Beyond the middle meatal antrostomy, EMMM can be used to effectively address RCMS. In cases that fail EMMM, removal of the condemned mucosa to encourage auto-obliteration of the sinus can be considered.
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Affiliation(s)
- Sei Y Chung
- Department of Otolaryngology Head and Neck Surgery, University of Texas Southwestern, Dallas, Texas, USA
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12
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Real-Life Experience in the Management of Sinonasal Complications of Dental Disease or Treatments. J Pers Med 2022; 12:jpm12122078. [PMID: 36556298 PMCID: PMC9781878 DOI: 10.3390/jpm12122078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Diagnosis and management of sinonasal complications of dental diseases or treatment (SCDDT) may be challenging. We aimed to report our real-life experience in patients treated with endoscopic endonasal approach describing data about symptoms, etiology, extension of the disease and success rate. We evaluated retrospectively data about 262 patients diagnosed as SCDDT and managed from August 2015 to May 2022. In 44.65% cases, maxillary sinus complications were determined by a dental disorder; the remaining 55.34% of cases were iatrogenic. Patients were managed according to our multidisciplinary protocol including ENT, dental, and radiological evaluation. Treatments were planned with a personalized approach, based on the patient’s clinical characteristics; all patients were treated with an endonasal endoscopic mini-invasive conservative approach. Combined dental treatment was performed simultaneously in 152/262 (58%) of patients; in the remaining cases, it was postponed after surgery. The overall treatment success rate (symptom resolution and endoscopically observed maxillary sinus healing) was 96.5%. At 15 days after surgery, we observed a significant improvement in the quality of life. The mean post-operative Sinonasal outcome test-22 (SNOT-22) score was significantly lower compared to baseline (6 versus 43.4; p < 0.05). Our study showed that endoscopic sinus surgery can be a successful procedure for treatment of SCDDT, leading to fast resolution of sinonasal symptoms and improving the quality of life. Furthermore, the technique allows removal of migrated dental material or dental implants even in challenging cases.
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Brescia G, Alessandrini L, Bacci C, Bissolotti G, Fedrigo M, Contro G, Frasconi S, Boccuto MG, Calcavecchia A, Frigo AC, Barion U, Fusetti S, Angelini A, Marioni G. Odontogenic Chronic Rhinosinusitis: Structured Histopathology Evidence in Different Patho-Physiological Mechanisms. Biomedicines 2022; 10:2768. [PMID: 36359287 PMCID: PMC9687938 DOI: 10.3390/biomedicines10112768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/23/2022] [Accepted: 10/27/2022] [Indexed: 08/30/2023] Open
Abstract
An increased odontogenic chronic rhinosinusitis (oCRS) occurrence rate has quite recently been reported, likely due to an intensification of conservative dental surgery and implantology. The main aim of the study was to report for the first time the structured histopathological characteristics of the surgical specimens of oCRS. Possible associations between histopathological features and oCRS patho-physiological mechanisms were also evaluated. Structured histopathology features were investigated in the sinonasal mucosa tissue of 42 consecutive oCRS patients.Mean tissue eosinophil counts were significantly different between oCRS with radicular cysts, dental implants, or other dental diseases (p =0.0118): mean tissue eosinophil count was higher in oCRS with dental implants. Sub-epithelial edema score and squamous metaplasia presence were significantly different when comparing the above-mentioned sub-cohorts of oCRS (p =0.0099 and p =0.0258). In particular, squamous metaplasia was more present in oCRS cases with radicular cysts than in those with a dental implant (p =0.0423). Fibrosis presence was significantly different comparing the three sub-cohorts of oCRS (p =0.0408), too. This preliminary evidence supports the hypothesis that: (i) structural histopathology can become a useful tool for clinic-pathological practice in diagnostic, therapeutic, and prognostic terms in CRS; (ii) that oCRS, as CRS in general, is a histo-pathologically heterogeneous disease; (iii) oCRS resulting from dental implants disorders can frequently be characterized as a CRS with a rich tissue eosinophilic component.
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Affiliation(s)
- Giuseppe Brescia
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Lara Alessandrini
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Christian Bacci
- Clinical Dentistry, Department of Neuroscience DNS, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Guido Bissolotti
- Maxillo-Facial Surgery Unit, Department of Neuroscience DNS, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Marny Fedrigo
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Giacomo Contro
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Samuele Frasconi
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Maria Grazia Boccuto
- Clinical Dentistry, Department of Neuroscience DNS, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Arianna Calcavecchia
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Anna Chiara Frigo
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Umberto Barion
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Stefano Fusetti
- Maxillo-Facial Surgery Unit, Department of Neuroscience DNS, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Annalisa Angelini
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Gino Marioni
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
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Plawecki AM, Saleem A, Zvirbulis D, Peterson EL, Yoo F, Ali A, Craig JR. Clinical Features and Headache Diagnoses in Patients With Chief Complaint of Craniofacial Pain. Ann Otol Rhinol Laryngol 2022; 132:628-637. [PMID: 35794798 DOI: 10.1177/00034894221111254] [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: 11/16/2022]
Abstract
OBJECTIVES Investigate the use of nasal endoscopy, sinus imaging, and neurologic evaluation in patients presenting to a rhinologist primarily for craniofacial pain. METHODS This was a retrospective analysis of consecutive outpatients presenting to a rhinologist between 2016 and 2019 with chief complaints of craniofacial pain with or without other sinonasal symptoms, who were then referred to and evaluated by headache specialists. Data analyzed included sinusitis symptoms, Sino-Nasal Outcome Test (SNOT-22) scores (and facial pain subscores), pain location, nasal endoscopy, computed tomography (CT) findings, and headache diagnoses made by headache specialists. RESULTS Of the 134 patients with prominent craniofacial pain, the majority of patients were diagnosed with migraine (50%) or tension-type (22%) headache, followed by multiple other non-sinogenic headache disorders. Approximately 5% of patients had headaches attributed to sinusitis. Amongst all patients, 90% had negative nasal endoscopies. Patients with negative endoscopies were significantly less likely to report smell loss (P = .003) compared to those with positive endoscopies. Poor agreement was demonstrated between self-reported pain locations and sinus findings on CT (kappa values < 0.20). Negative nasal endoscopy showed high concurrence with negative CT findings (80%-97%). CONCLUSIONS Patients presenting with chief complaints of craniofacial pain generally met criteria for various non-sinogenic headache disorders. Nasal endoscopy was negative in 90% of patients, and CT demonstrated poor agreement with pain locations. Nasal endoscopy and CT shared high concurrence rates for negative sinus findings. The value of nasal endoscopy over sinus imaging in craniofacial pain evaluation should be explored in future studies.
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Affiliation(s)
- Andrea M Plawecki
- Department of Otolaryngology-Head & Neck Surgery, Henry Ford Health, Detroit, MI, USA
| | - Abdulmalik Saleem
- Michigan State University College of Human Medicine, East Lansing, MI, USA
| | - Dace Zvirbulis
- Department of Neurology, Henry Ford Health, Detroit, MI, USA
| | - Edward L Peterson
- Department of Public Health Sciences, Henry Ford Health, Detroit, MI, USA
| | - Frederick Yoo
- Department of Otolaryngology-Head & Neck Surgery, Kaiser Permanente, Orange County, CA, USA
| | - Ashhar Ali
- Department of Neurology, Henry Ford Health, Detroit, MI, USA
| | - John R Craig
- Department of Otolaryngology-Head & Neck Surgery, Henry Ford Health, Detroit, MI, USA
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Allevi F, Fadda GL, Rosso C, Martino F, Pipolo C, Cavallo G, Felisati G, Saibene AM. Treatment of Sinusitis Following Dental Implantation: A Systematic Review and Meta-Analysis. Am J Rhinol Allergy 2022; 36:539-549. [PMID: 35244478 DOI: 10.1177/19458924221084484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Implantological procedures aimed at rehabilitating upper jaw edentulous patients (dental implant placement and/or maxillary sinus grafting) can sporadically result in sinusitis. In these patients, endoscopic sinus surgery is the most commonly employed treatment, but clinical scenarios and comprehensive management strategies are extremely heterogeneous across studies. OBJECTIVE We sought to systematically define treatment strategies and related success rates for sinusitis following dental implantation, detailing different current treatment choices and concepts. METHODS Adopting a PRISMA-compliant review framework, systematic searches were performed in multiple databases using criteria designed to include all studies published until November 2020 focusing on the treatment of human sinusitis following dental implantation. We selected all original studies, excluding case reports, specifying treatment modalities with objective treatment success definitions. Following duplicate removal, abstract and full-text selection, and quality assessment, we reviewed eligible articles for treatment modalities and success rates, which were pooled in a random-effects meta-analysis. RESULTS Among 581 unique citations, eight studies (181 patients) were selected. Seven studies were retrospective case series. All studies relied on endoscopic sinus surgery, often coupled with intraoral accesses, and assessed therapeutic success endoscopically. The pooled treatment success rate was 94.7% (95% confidence interval, 91.5%-98%). Failures were treated in seven of 15 cases with further antibiotic therapies and in another seven cases with surgical revision. A single patient was lost to follow-up. CONCLUSIONS Endoscopic sinus surgery appears to be the most frequent treatment of choice for sinusitis following dental implantation, with excellent success rates. The protean clinical picture drawn from the selected studies calls for the standardization of diagnostics and definitions in this field to enable direct comparisons between the results of different studies. The role of postoperative antibiotic therapies, which have been employed unevenly across studies, should also be prospectively investigated.
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Affiliation(s)
- Fabiana Allevi
- Maxillofacial Surgery Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- ISGOS, the Italian Study Group on Odontogenic Sinusitis
| | - Gian Luca Fadda
- ISGOS, the Italian Study Group on Odontogenic Sinusitis
- Department of Otorhinolaryngology, San Luigi Gonzaga University Hospital, Università degli Studi di Torino, Turin, Italy
| | - Cecilia Rosso
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Federica Martino
- Unit of Otorhinolaryngology, Department of Clinical Sciences and Translational Medicine, University of Tor Vergata, Rome, Italy
| | - Carlotta Pipolo
- ISGOS, the Italian Study Group on Odontogenic Sinusitis
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Cavallo
- ISGOS, the Italian Study Group on Odontogenic Sinusitis
- Department of Otorhinolaryngology, San Luigi Gonzaga University Hospital, Università degli Studi di Torino, Turin, Italy
| | - Giovanni Felisati
- ISGOS, the Italian Study Group on Odontogenic Sinusitis
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Alberto Maria Saibene
- ISGOS, the Italian Study Group on Odontogenic Sinusitis
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
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16
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Presence of anaerobic bacteria and symptoms supports diagnosis of odontogenic sinusitis. Am J Otolaryngol 2022; 43:103544. [DOI: 10.1016/j.amjoto.2022.103544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 07/24/2022] [Indexed: 11/23/2022]
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17
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Craig JR. Odontogenic sinusitis: A state‐of‐the‐art review. World J Otorhinolaryngol Head Neck Surg 2022; 8:8-15. [PMID: 35619928 PMCID: PMC9126162 DOI: 10.1002/wjo2.9] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/01/2021] [Indexed: 01/07/2023] Open
Abstract
Odontogenic sinusitis (ODS) is more common than historically reported, and is underrepresented in the sinusitis literature. ODS is distinct from rhinosinusitis in that it is infectious sinusitis from an infectious dental source or a complication from dental procedures, and most commonly presents unilaterally. ODS clinical features, microbiology, and diagnostic and treatment paradigms are also distinct from rhinosinusitis. ODS evaluation and management should generally be conducted by both otolaryngologists and dental providers, and clinicians must be able to suspect and confirm the condition. ODS suspicion is driven by certain clinical features like unilateral maxillary sinus opacification on computed tomography, overt maxillary dental pathology on computed tomography, unilateral middle meatal purulence on nasal endoscopy, foul smell, and odontogenic bacteria in sinus cultures. Otolaryngologists should confirm the sinusitis through nasal endoscopy by assessing for middle meatal purulence, edema, or polyps. Dental providers should confirm dental pathology through appropriate examinations and imaging. Once ODS is confirmed, a multidisciplinary shared decision‐making process should ensue to discuss risks and benefits of the timing and different types of dental and sinus surgical interventions. Oral antibiotics are generally ineffective at resolving ODS, especially when there is treatable dental pathology. When both the dental pathology and sinusitis are addressed, resolution can be expected in 90%–100% of cases. For treatable dental pathology, while primary dental treatment may resolve the sinusitis, a significant percentage of patients still require endoscopic sinus surgery. For patients with significant sinusitis symptom burdens, primary endoscopic sinus surgery is an option to resolve symptoms faster, followed by appropriate dental management. More well‐designed studies are necessary across all areas of ODS. Odontogenic sinusitis (ODS) is one of the most common cause of unilateral maxillary sinus disease, but has been underrepresented in previous sinusitis literature. Clinicians must be able to suspect ODS based on certain clinical features like unilateral middle meatal purulence on nasal endoscopy, subjective foul smell, and sinus computed tomography demonstrating maxillary sinus opacification with or without overt adjacent dental pathology. Diagnosing ODS requires confirmation of infectious sinusitis by otolaryngologists ideally with nasal endoscopy, and confirmation of adjacent maxillary dental pathology by dental specialists. Management centers on multidisciplinary collaboration and shared‐decision making between otolaryngologists, dental specialists, and patients.
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Affiliation(s)
- John R. Craig
- Department of Otolaryngology‐Head and Neck Surgery Henry Ford Health System Detroit Michigan USA
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18
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Yoshida H, Sakashita M, Adachi N, Matsuda S, Fujieda S, Yoshimura H. Relationship between infected tooth extraction and improvement of odontogenic maxillary sinusitis. Laryngoscope Investig Otolaryngol 2022; 7:335-341. [PMID: 35434313 PMCID: PMC9008179 DOI: 10.1002/lio2.765] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 02/06/2022] [Accepted: 02/16/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- Hisato Yoshida
- Department of Dentistry and Oral Surgery, Unit of Sensory and Locomotor Medicine, Division of Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Masafumi Sakashita
- Department of Otorhinolaryngology Head & Neck Surgery, Unit of Sensory and Locomotor Medicine, Faculty of Medical Science University of Fukui Fukui Japan
| | - Naoto Adachi
- Department of Otorhinolaryngology Head & Neck Surgery, Unit of Sensory and Locomotor Medicine, Faculty of Medical Science University of Fukui Fukui Japan
| | - Shinpei Matsuda
- Department of Dentistry and Oral Surgery, Unit of Sensory and Locomotor Medicine, Division of Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Shigeharu Fujieda
- Department of Otorhinolaryngology Head & Neck Surgery, Unit of Sensory and Locomotor Medicine, Faculty of Medical Science University of Fukui Fukui Japan
| | - Hitoshi Yoshimura
- Department of Dentistry and Oral Surgery, Unit of Sensory and Locomotor Medicine, Division of Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
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19
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Tsuda T, Takeda K, Terada R, Tanaka S, Waki S, Akama T, Nishimura H. Osteitis in Diseases With Unilateral Opacification of Paranasal Sinuses. EAR, NOSE & THROAT JOURNAL 2022:1455613221074957. [PMID: 35081796 DOI: 10.1177/01455613221074957] [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: 11/15/2022] Open
Abstract
OBJECTIVES Chronic rhinosinusitis (CRS) is a common disease with mucosal inflammation, and may sometimes be accompanied by bone thickening. The disease is usually bilateral; when it is unilateral, there may be a specific disease. This study aimed to investigate the association between unilateral sinus opacification and osteitis. METHODS In total, 104 patients with computed tomography revealing unilateral sinus opacification were included in this study. Patients were retrospectively evaluated using the Global Osteitis Scoring Scale (GOSS) score, Lund-Mackey (LM) score, polyp score, and blood tests. RESULTS In total, 47, 11, 9, 17, and 20 patients had CRS, paranasal sinus cyst, inverted papilloma, mycetoma, and odontogenic sinusitis, respectively. The GOSS score in patients with mycetoma was higher than that in patients with CRS. However, no significant differences in the GOSS scores between patients with mycetoma, inverted papilloma, and odontogenic sinusitis existed. 10 of the 104 patients had osteitis with extensive bone thickening and a GOSS score of 4 or higher. Patients with CRS and mycetoma tended to have a higher GOSS score for the maxillary sinus than for the other sinuses. There was a significant positive correlation between the GOSS score and LM score in patients with diseases other than paranasal sinus cyst. CONCLUSIONS Mycetoma is more likely to cause osteitis than CRS, and a unique mechanism of osteitis exacerbation is predicted. As there is a positive correlation between bone thickening and sinus inflammation, a close association between osteitis and mucosal inflammation is inferred in diseases involving unilateral sinus opacification.
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Affiliation(s)
- Takeshi Tsuda
- Department of Otorhinolaryngology, 13707National Hospital Organization Osaka National Hospital, Chu-ouku, Osaka City, Osaka, Japan
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Kazuya Takeda
- Department of Otolaryngology, 38158Kindai University Faculty of Medicine, Osakasayama City, Osaka, Japan
| | - Risa Terada
- Department of Otorhinolaryngology, 13707National Hospital Organization Osaka National Hospital, Chu-ouku, Osaka City, Osaka, Japan
| | - Shohei Tanaka
- Department of Otorhinolaryngology, 13707National Hospital Organization Osaka National Hospital, Chu-ouku, Osaka City, Osaka, Japan
| | - Sadanori Waki
- Department of Otorhinolaryngology, 13707National Hospital Organization Osaka National Hospital, Chu-ouku, Osaka City, Osaka, Japan
| | - Toshiyuki Akama
- Department of Otorhinolaryngology, 13707National Hospital Organization Osaka National Hospital, Chu-ouku, Osaka City, Osaka, Japan
| | - Hiroshi Nishimura
- Department of Otorhinolaryngology, 13707National Hospital Organization Osaka National Hospital, Chu-ouku, Osaka City, Osaka, Japan
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20
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Ten-year experience with multidisciplinary diagnosis and treatment of odontogenic sinusitis. The Journal of Laryngology & Otology 2021; 135:987-992. [PMID: 34470684 DOI: 10.1017/s0022215121002310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Odontogenic sinusitis is an underdiagnosed entity and is one cause of failure of conventional treatments of sinusitis. Unfortunately, there is no consensus so far on the best management protocol. This retrospective study aimed to suggest a practical management protocol that can reduce misdiagnosis and improve treatment outcomes. METHODS The study included 74 patients with confirmed odontogenic sinusitis who were diagnosed and treated over 10 years (2010-2019). The patient data were recorded and analysed. RESULTS Dental pain was reported in only 31.1 per cent of patients. Fifty-six patients (75.7 per cent) had received dental treatment during the last year, but only 13 (23.1 per cent) reported it. Dental pathology was missed on initial computed tomography evaluation in 24 patients (32.4 per cent). Forty-one patients (55.4 per cent) were successfully treated by dental procedures and antibiotics. Fourteen patients needed functional endoscopic sinus surgery in addition to dental procedures. CONCLUSION Successful management of odontogenic sinusitis requires good communication between rhinologists, radiologists and dentists. Dental treatment should be the logical first step in the treatment protocol, unless otherwise indicated.
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21
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Craig JR, Tataryn RW, Sibley HC, Mason WD, Deuel JA, Loyd GE, Nerenz DR, Goyal P. Expected Costs of Primary Dental Treatments and Endoscopic Sinus Surgery for Odontogenic Sinusitis. Laryngoscope 2021; 132:1346-1355. [PMID: 34418111 DOI: 10.1002/lary.29825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/02/2021] [Accepted: 08/08/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Treatment of odontogenic sinusitis (ODS) due to apical periodontitis (AP) is highly successful when both dental treatment and endoscopic sinus surgery (ESS) are performed. Variation exists in the literature with regard to types and timing of dental treatments and ESS when managing ODS. This study modeled expected costs of different primary dental and sinus surgical treatment pathways for ODS due to AP. STUDY DESIGN Decision-tree economic model. METHODS Decision-tree models were created based on cost and treatment success probabilities. Using Medicare and consumer online databases, cost data were obtained for the following dental and sinus surgical treatments across the United States: root canal therapy (RCTx), revision RCTx, apicoectomy, extraction, dental implant, bone graft, and ESS (maxillary, ± anterior ethmoid, ± frontal). A literature review was performed to determine probabilities of dental and sinus disease resolution after different dental treatments. Expected costs were determined for primary dental extraction, RCTx, and ESS pathways, and sensitivity analyses were performed. RESULTS Expected costs for the three different primary treatment pathways when dental care was in-network and all diseased sinuses opened during ESS were as follows: dental extraction ($4,753.83), RCTx ($4,677.34), and ESS ($7,319.85). CONCLUSIONS ODS due to AP can be successfully treated with primary dental treatments, but ESS is still frequently required. Expected costs of primary dental extraction and RCTx were roughly equal. Primary ESS had a higher expected cost, but may still be preferred in patients with prominent sinonasal symptoms. Patients' insurance coverage may also impact decision-making. LEVEL OF EVIDENCE N/A Laryngoscope, 2021.
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Affiliation(s)
- John R Craig
- Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan, U.S.A
| | - Roderick W Tataryn
- Tataryn Endodontics, Spokane, Washington, U.S.A.,Department of Endodontics, School of Dentistry, Loma Linda University, Loma Linda, California, U.S.A
| | - Haley C Sibley
- Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan, U.S.A
| | | | - Joshua A Deuel
- Department of Oral Maxillofacial Surgery, Henry Ford Health System, Detroit, Michigan, U.S.A
| | - Gary E Loyd
- Department of Anesthesiology, Henry Ford Health System, Detroit, Michigan, U.S.A
| | - David R Nerenz
- Henry Ford Health System, Department of Neurosurgery, Center for Health Policy and Health Services Research, Detroit, Michigan, U.S.A
| | - Parul Goyal
- Syracuse Otolaryngology, Syracuse, New York, U.S.A
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22
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Solares CA. Interdisciplinary Teamwork within the Medical Profession: The Way of the Future. Am J Rhinol Allergy 2021; 35:148-151. [PMID: 33557586 DOI: 10.1177/1945892421992580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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