Diagnosing odontogenic sinusitis: An international multidisciplinary consensus statement

Craig, John R.; Poetker, David M.; Aksoy, Umut; Allevi, Fabiana; Biglioli, Federico; Bruce, Y.; Chiapasco, Matteo; Lechien, J; Safadi, Ahmad; Simuntis, Regimantas; Tataryn, Roderick W.; Testori, Tiziano; Troeltzsch, Matthias; Vaitkus, Saulius; Yokoi, Hidenori; Felisati, Giovanni; Saibene, Alberto Maria

doi:10.1002/alr.22777

Cited by 61 publications

(127 citation statements)

References 58 publications

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“…First, there has been an overall paucity of ODS publications in the sinusitis literature, 15 and only recently has international consensus been reached on diagnosing ODS. 4 In addition, as demonstrated in this review, only 23% of complicated ODS studies have been published in the otolaryngology literature. Taken together, these factors make it possible that ODS has been underrecognized as a cause of complicated sinusitis.…”

Section: Discussionmentioning

confidence: 88%

“…When dental pathology is considered, patients should be evaluated by dental specialists for dental testing, examination, and imaging as needed. 4,6…”

Section: Discussionmentioning

confidence: 99%

“…When dental pathology is considered, patients should be evaluated by dental specialists for dental testing, examination, and imaging as needed. 4,6 When managing extrasinus complications, one must address the extrasinus complications as well as infectious sources. For rhinosinusitis, it has been recommended that unless patients meet emergency surgery criteria, patients should receive 48 hours of intravenous antibiotics with close monitoring for deterioration.…”

Section: Diagnosis and Managementmentioning

confidence: 99%

“…Odontogenic sinusitis (ODS) refers to bacterial maxillary sinusitis, with or without extension to other paranasal sinuses, secondary to either adjacent infectious maxillary dental pathology or following complications from dental procedures. 4,5 Potential dental pathologies causing ODS include apical periodontitis with or without periapical lesions (endodontic infection), marginal periodontitis (periodontal infection), oroantral communication or fistula, or dental treatment–related maxillary sinus foreign bodies. 6-8 Studies have shown that ODS could account for 25% to 40% of all chronic maxillary sinusitis 9,10 and 45% to 75% of unilateral maxillary sinus opacification on computed tomography (CT).…”

mentioning

confidence: 99%

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Extrasinus Complications From Odontogenic Sinusitis: A Systematic Review

Craig¹,

Cheema²,

Dunn

et al. 2021

Otolaryngol.--head neck surg.

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Objective Odontogenic sinusitis (ODS) can cause infectious orbital, intracranial, and osseous complications. Diagnosis and management of complicated ODS have not been discussed in recent sinusitis guidelines. The purpose of this systematic review was to describe epidemiological and clinical features, as well as management strategies of complicated ODS. Data Sources PubMed, EMBASE, and Cochrane Library. Review Methods A systematic review was performed to describe various features of complicated ODS. All complicated ODS studies were included in qualitative analysis, but studies were only included in quantitative analysis if they reported specific patient-level data. Results Of 1126 studies identified, 75 studies with 110 complicated ODS cases were included in qualitative analysis, and 47 studies with 62 orbital and intracranial complications were included in quantitative analyses. About 70% of complicated ODS cases were orbital complications. Only 23% of complicated ODS studies were published in otolaryngology journals. Regarding ODS-related orbital and intracranial complications, about 80% occurred in adults, and 75% were male. Complicated ODS occurred most commonly from apical periodontitis of maxillary molars. There were no relationships between sinusitis extent and orbital or intracranial complications. High rates of anaerobic and α-hemolytic streptococcal bacteria were identified in complicated ODS. Management generally included systemic antibiotics covering aerobic and anaerobic bacteria, and surgical interventions were generally performed to address both the complications (orbital and/or intracranial) and possible infectious sources (dentition and sinuses). Conclusion ODS should be considered in all patients with infectious extrasinus complications. Multidisciplinary management between otolaryngologists, dental specialists, ophthalmologists, and neurosurgeons should be considered to optimize outcomes.

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Section: Discussionmentioning

confidence: 88%

“…When dental pathology is considered, patients should be evaluated by dental specialists for dental testing, examination, and imaging as needed. 4,6…”

Section: Discussionmentioning

confidence: 99%

Section: Diagnosis and Managementmentioning

confidence: 99%

mentioning

confidence: 99%

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Extrasinus Complications From Odontogenic Sinusitis: A Systematic Review

Craig¹,

Cheema²,

Dunn

et al. 2021

Otolaryngol.--head neck surg.

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“…Delphi study is commonly used in health care to achieve an international expert consensus for developing clinical guidelines or for defining newly emerged concepts [ 19 , 22 , 27 ]. However, the findings of this present study suggest that the appropriateness and feasibility of the statements were major concerns of the panelists, thereby highlighting the importance of deriving statements that are socio-culturally specific to the local context.…”

Section: Discussionmentioning

confidence: 99%

Key Components for the Delivery of Palliative and End-of-Life Care in Care Homes in Hong Kong: A Modified Delphi Study

Chan

Chan²,

Man³

et al. 2022

IJERPH

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Integrating the palliative care approach into care home service to address the complex care needs of older adults with frailty or advanced diseases has been increasingly recognized. However, such a service is underdeveloped in Hong Kong owing to socio-cultural and legal concerns. We adopted a modified Delphi study design to identify the key components for the delivery of palliative and end-of-life care in care home settings for the local context. It was an iterative staged method to assimilate views of experts in aged care, palliative care, and care home management. A multidisciplinary expert panel of 18 members consented to participate in the study. They rated their level of agreement with 61 candidate statements identified through a scoping review in two rounds of anonymous surveys. The steering group revised the statements in light of the survey findings. Eventually, the finalized list included 28 key statements concerning structure and process of care in seven domains, namely policy and infrastructure, education, assessment, symptom management, communication, care for dying patients, and family support. The findings of this study underscored concerns regarding the feasibility of statements devised at different levels of palliative care development. This list would be instrumental for regions where the development of palliative and end-of-life care services in care home setting is at an initial stage.

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Comprehensive management of paranasal sinus fungus balls: A Young‐IFOS consensus statement

Saibene¹,

Allevi

Calvo-Henríquez³

et al. 2022

Int Forum Allergy Rhinol

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Background: Paranasal sinus fungus balls (PSFB) are a common form of surgically treatable, noninvasive mycosis. To date, no guidelines have standardized PSFB treatment or management of difficult cases (eg, immunocompromised or fragile patients). The clinical consensus statement presented herein aims to provide a comprehensive management guide to PSFB based on current evidence.Methods: A multidisciplinary, international panel of 19 specialists judged statements in 3 rounds of a modified Delphi method survey. Statements encompassed the following PSFB management issues: definition, diagnostic workup; treatment indications and modalities; and follow-up. Otolaryngologists, maxillofacial surgeons, infectious disease specialists, and transplant physicians were considered the target audience. Results: Among the 23 statements, 7 reached strong consensus and 16 reached consensus. Consensus was reached on the definition, diagnosis, and treatment modalities for PSFB. Postoperative follow-up modalities and scenarios with bacterial superinfection were the most debated issues. Conclusion: Until further data are available, these points provide a framework for the management of PSFB. Moreover, PSFB should be considered a noninvasive mycosis that is not necessarily symptomatic or related to odontogenic conditions. Although diagnosis may be incidental, endoscopy and single imaging (computed tomography or magnetic resonance imaging, with distinctive features) are required for diagnosis, whereas contrast medium would allow for differential diagnosis. Although treatment of PSFB should be considered mandatory before sinus augmentation and is recommended for symptomatic patients, immunosuppressed patients, or patients with planned immunosuppression, watchful waiting could be considered for asymptomatic patients with chronic rhinosinusitis who are provided with appropriate advice and assessment.

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Diagnosing odontogenic sinusitis: An international multidisciplinary consensus statement

Cited by 61 publications

References 58 publications

Extrasinus Complications From Odontogenic Sinusitis: A Systematic Review

Extrasinus Complications From Odontogenic Sinusitis: A Systematic Review

Key Components for the Delivery of Palliative and End-of-Life Care in Care Homes in Hong Kong: A Modified Delphi Study

Comprehensive management of paranasal sinus fungus balls: A Young‐IFOS consensus statement

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