Nonsurgical treatment for odontogenic maxillary sinusitis using irrigation through the root canal: preliminary case report

The employment of thermographic examinations in the diagnostics of diseases of the paranasal sinuses

OBJECTIVES

The article was aimed at assessing the diagnostic value of a thermographic examination of the pathology of the paranasal sinuses.

METHODS

39 patients met the inclusion criteria for the study. The cases of unilateral inflammations of the maxillary sinuses (odontogenic and non-odontogenic, acute and chronic) were chosen on the basis of a comprehensive panel of diagnostic tests including among other things: a radiological examination, endoscopy, the histopathological assessment of the state of the collected mucous membrane. The thermographic examination was carried out on the day preceding the surgery in the ward after finishing full clinical and radiological diagnostics. The measurements were conducted in accordance with the recommendations of the European Society of Thermology with the use of a FLIR E50 thermal imaging camera. The differences of the maximum temperatures (ΔT_max) between the affected side and the healthy side were characterized. The recorded thermal parameters were related to the totality of cases, the patients' age and gender, the category of clinical diagnoses in respect of aetiology, the presence of communication of the oral cavity with the maxillary sinus, changes in the radiological image and the degree of their intensity, a histopathological diagnosis, the presence of acute symptoms in the past as well as the time which elapsed between the occurrence of the first clinical symptoms of sinusitis noticed by the patients and the moment of surgical treatment implementation.

RESULTS

When the oroantral fistulas were present, a highly significant relationship between T_max of the affected and healthy sides was found (p = 0.0095). Odontogenic vs non-odontogenic aetiology seemed to have a significant influence on these temperature differences (p = 0.0133). ΔT_max links also with the state of the mucous membrane assessed during endoscopy (p = 0.038).

CONCLUSIONS

A thermographic examination can be only an auxiliary examination in the diagnostics of the diseases of the maxillary sinuses and may be helpful in the initial assessment of a chronic unilateral pathology.