Extrasinus Complications From Odontogenic Sinusitis: A Systematic Review

Craig, John R.; Cheema, Atif J; Dunn, Raven T.; Vemuri, Swapna; Peterson, Edward L.

doi:10.1177/01945998211026268

Cited by 27 publications

(29 citation statements)

References 50 publications

(127 reference statements)

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“…With regard to sinus cultures, ODS patients have higher rates of alpha‐hemolytic streptococcal species and anaerobes compared to rhinosinusitis patients 12,21,30,31 . Lastly, compared to rhinosinusitis, ODS tends to demonstrate relative sparing of the posterior ethmoid and sphenoid sinuses on CT 1,2,16,29 . All these clinical features reached consensus as being more associated with ODS compared to other forms of rhinosinusitis.…”

Section: Diagnosing Odsmentioning

confidence: 98%

“…Clinicians should assess for odontogenic sources in all cases of complicated sinusitis. Multidisciplinary management of complicated ODS is essential to drain extrasinus abscesses and to eliminate the infectious dental and sinus sources 16 …”

Section: Important Clinical Scenariosmentioning

confidence: 99%

“…While no studies have reported on the clinical course of asymptomatic ODS, a shared decision‐making process should still ensue. One point to highlight to these patients is the potential for extrasinus infectious spread 16 . Therefore patients should be encouraged at a minimum to undergo dental treatment to eliminate the dental infectious source.…”

Section: Important Clinical Scenariosmentioning

confidence: 99%

“…ODS most commonly presents in the 5th decade of life, affects males and females equally, and patients typically have chronic symptoms (median, 6 months) 2 . While ODS most commonly presents chronically, it can present acutely with extrasinus orbital, intracranial, or osseous infectious spread 16 . Potential dental pathologies causing ODS include apical periodontitis (AP; endodontic disease stemming from pulpal necrosis), marginal periodontitis, oroantral communication or fistula (OAC or OAF), or dental‐treatment‐related foreign bodies within the maxillary sinus 7,12,17–22 .…”

Section: Introductionmentioning

confidence: 99%

“… 2 While ODS most commonly presents chronically, it can present acutely with extrasinus orbital, intracranial, or osseous infectious spread. 16 Potential dental pathologies causing ODS include apical periodontitis (AP; endodontic disease stemming from pulpal necrosis), marginal periodontitis, oroantral communication or fistula (OAC or OAF), or dental‐treatment‐related foreign bodies within the maxillary sinus. 7 , 12 , 17 , 18 , 19 , 20 , 21 , 22 AP and OAC/OAF have been the most commonly reported causes of ODS.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Odontogenic sinusitis: A state‐of‐the‐art review

Craig

2022

World j. otorhinolaryngol.-head neck surg.

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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.

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Section: Diagnosing Odsmentioning

confidence: 98%

Section: Important Clinical Scenariosmentioning

confidence: 99%

Section: Important Clinical Scenariosmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Odontogenic sinusitis: A state‐of‐the‐art review

Craig

2022

World j. otorhinolaryngol.-head neck surg.

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A potentially fatal cranial pathology in a specimen of Tarchia

Tumanova

Penkalski

Gallagher

et al. 2023

The Anatomical Record

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Skulls of the Mongolian ankylosaurids Shamosaurus, Tarchia, and Saichania were scanned for information about their internal anatomy. Computed tomography (CT) imaging of the Tarchia skull revealed substantial internal anatomical differences from known Campanian North American taxa, particularly in the morphology of the airway. In addition, unexpected anomalies were detected within the airway and sinuses. The anomalies include multiple bilaterally distributed, variably sized hyperdense (mineralized) concretions within the airway and sinuses, the largest of which, positioned in the right nasal cavity medial to the supraorbitals, has an asymmetric ovoid shape that tapers caudally and which is partially encased within a hemispherical trabeculated osseous proliferation (sinus exostosis). Immediately adjacent to the exostosis is a subcircular transosseous defect in the prefrontal region of the skull roof that is partially filled with trabeculated ossified material with similar architectural features as the larger exostosis. Irregularities along the internal and external surfaces of the cranial vault may be associated. The radiologic features of the hemicircumferential exostosis suggest a chronic reactive osteoproliferation, possibly in response to an ongoing inflammatory reaction to primary sinus infection or, in combination with the unilateral transosseous defect, traumatically introduced infection with potentially fatal consequences. This report underscores the value of CT scanning of fossil vertebrate specimens, which in this case revealed large internal lesions of the skull that, at the time the scan was performed, were otherwise indiscernible.

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Maxillary Sinusitis Following Orthognathic Surgery: Should It Be Considered Odontogenic Sinusitis?

Imbrogno,

Lorenzi,

Borloni

et al. 2024

Clinical Case Reports

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Maxillary sinusitis is a recognized complication following dental procedures, but its occurrence after orthognathic surgery, such as Le Fort osteotomies, remains less documented. This case report presents a 58‐year‐old female who developed unilateral maxillary sinusitis 23 years post‐orthognathic surgery. The patient was asymptomatic, aside from occasional cacosmia, and was incidentally found to have sinus opacification on a computed tomography (CT) scan performed for implant‐prosthetic rehabilitation. Nasal endoscopy revealed purulence and mucosal edema, prompting endoscopic sinus surgery (ESS). Intraoperatively, purulent material and fungal debris were removed from the maxillary sinus, confirming bacterial sinusitis with a concurrent fungal ball. S. salivarius and Klebsiella species were identified from the cultures. The patient's condition improved following the removal of both the sinus contents and the retained titanium plates and screws. This case underscores the potential for maxillary sinusitis to develop long after orthognathic surgery, particularly in the presence of retained dental hardware. It highlights the importance of thorough imaging and endoscopic evaluation in patients with a history of dental or facial surgeries presenting with sinonasal symptoms. Additionally, it raises questions about the role of retained hardware in the persistence or recurrence of infection and the possible association with fungal ball formation. The need for further research to establish guidelines for the management of sinusitis in such contexts, particularly regarding the removal of facial hardware, is emphasized.

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Extrasinus Complications From Odontogenic Sinusitis: A Systematic Review

Cited by 27 publications

References 50 publications

Odontogenic sinusitis: A state‐of‐the‐art review

Odontogenic sinusitis: A state‐of‐the‐art review

A potentially fatal cranial pathology in a specimen of Tarchia

Maxillary Sinusitis Following Orthognathic Surgery: Should It Be Considered Odontogenic Sinusitis?

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