Clinical and radiologic findings in a case series of maxillary sinusitis of dental origin

Pokorny, Al; Tataryn, Roderick W.

doi:10.1002/alr.21212

Cited by 77 publications

(103 citation statements)

References 15 publications

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“…ODS is diagnosed in a fashion similar to other forms of sinusitis: history to detect sinusitis symptoms, nasal endoscopy to assess for inflammation or infection, and computed tomography (CT) imaging to assess sinusitis extent but also maxillary odontogenic pathology. Sinonasal symptoms of ODS are consistent with cardinal symptoms of acute and chronic sinusitis, although ODS symptoms are more commonly unilateral . Anterior and posterior nasal drainage are most frequently reported in ODS in 60% or more of patients .…”

Section: Introductionmentioning

confidence: 75%

“…Sinus CT for ODS often shows maxillary odontogenic pathology, but radiologists frequently overlook the dental pathology . Otolaryngologists must therefore carefully assess maxillary dentition on CT. Additionally, one series found that about one‐third of ODS cases revealed no dental pathology on sinus CT . Sinus cultures in ODS are usually polymicrobial, with a higher likelihood of anaerobes compared with sinogenic sinusitis .…”

Section: Introductionmentioning

confidence: 99%

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Optimal timing of endoscopic sinus surgery for odontogenic sinusitis

et al. 2019

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Objectives Odontogenic sinusitis (ODS) is more common than historically reported, and management recommendations are limited in the literature. Although ODS case series have shown successful outcomes with dental treatment and endoscopic sinus surgery (ESS), no studies have considered the optimal timing of these treatments. The purpose of this study was to analyze times to ODS resolution after primary dental treatment and ESS based on symptom, 22‐item sinonasal outcome test (SNOT‐22), and endoscopic outcomes. Study Design Prospective cohort study. Methods Thirty‐seven symptomatic ODS patients who failed medical management were offered primary dental treatment or ESS. Eleven patients selected primary dental treatment, and 26 patients selected ESS. The following variables were collected prospectively at every office visit before and after dental treatment or ESS: SNOT‐22, presence or absence of cardinal sinusitis symptoms, and presence or absence of middle meatal endoscopy findings (edema, polyps, purulence). Times to resolution of these clinical variables were analyzed with t test, chi‐square test, Fisher exact test, McNemar test, and Kaplan‐Meier survival analysis. Results Patients in the dental treatment and ESS groups showed no significant differences in preoperative sinusitis disease burdens based on symptoms, SNOT‐22, endoscopy, and computed tomography. The ESS group experienced faster and more significant improvement in nearly all symptom, SNOT‐22, and endoscopic outcomes. Conclusions For symptomatic ODS, primary ESS resulted in faster resolution of SNOT‐22, sinusitis symptoms, and endoscopic findings in ODS patients compared with primary dental treatment. ESS can be considered first‐line therapy for symptomatic ODS, followed by dental treatment when necessary. Level of Evidence 2b Laryngoscope, 129:1976–1983, 2019

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Section: Introductionmentioning

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Optimal timing of endoscopic sinus surgery for odontogenic sinusitis

et al. 2019

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“…More than 70% of maxillofacial CT scans showing unilateral maxillary sinusitis may be attributable to an odontogenic infection . However, several studies have documented that dental disease may be frequently overlooked on CT by radiologists leading to misdiagnosis . As a result, clinicians should carefully analyze maxillary dentition when interpreting maxillofacial CT scans, particularly in the setting of unilateral maxillary sinusitis .…”

Section: Introductionmentioning

confidence: 99%

Odontogenic sinusitis: A review of the current literature

Little

Long

Loehrl

et al. 2018

Laryngoscope Investig Oto

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106

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ObjectivesTo present current literature on the topic of odontogenic sinusitis.Data SourcePubMed literature search for odontogenic sinusitis.ResultsOdontogenic sinusitis is an inflammatory condition of the paranasal sinuses that is the result of dental pathology, most often resulting from prior dentoalveolar procedures, infections of maxillary dentition, or maxillary dental trauma. Infections are often polymicrobial with an anaerobe‐predominant microbiome requiring special considerations for antimicrobial therapy. Medical management and treatment of the underlying dental pathology remains a critical initial step in the treatment of odontogenic sinusitis, however recent literature suggests that a significant portion of patients may require endoscopic sinus surgery for successful disease resolution.ConclusionsThis review describes the essential epidemiological and etiological factors, relevant clinical findings and diagnostic modalities, microbiologic and antimicrobial considerations, as well as the medical and surgical treatment approaches commonly utilized for the management of odontogenic sinusitis.Level of EvidenceNA.

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“…5,9 Patients who have these underlying disease states may deny sinus symptoms at the time of presentation, yet it has been found that 12 to 65% of patients presenting for maxillary reconstruction exhibit abnormal thickening of the sinus membrane. 1,2,[4][5][6][7][8][9][10]13,14 The hypotheses of this retrospective review of CBCT scans were that 1) sinus membrane thickening is strongly correlated with the health of posterior maxillary teeth and 2) definitive treatment of unhealthy teeth in the posterior maxilla would decrease sinus membrane thickening after 3 to 6 months.…”

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confidence: 99%