Questioning the Justification of Frontal Sinusotomy for Odontogenic Sinusitis

Safadi, Ahmad; Kleinman, Shlomi; Oz, Itay; Wengier, Anat; Mahameed, Fadi; Vainer, Igor; Ungar, Omer J.

doi:10.1016/j.joms.2019.12.025

Cited by 14 publications

(19 citation statements)

References 20 publications

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“…According to most publications, the laterality of sinusitis due to odontogenic causes is the most common ( Table 8 ) [ 18 , 24 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ]. However, we found in this study that bilateral changes were observed in 17.9% of patients, which is in line with the results obtained by Wang et al [ 34 ] and Saibene et al [ 25 ], who found bilateral involvement to be between 16 and 19% and to be 18.7%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the Radiological Changes of the Sinus Membrane Using Cone Beam Computed Tomography and Its Relationship with Dental Treatments. A Retrospective Study

Rey-Martínez¹,

Ruiz-Sáenz

Martínez-Rodríguez

et al. 2022

Biology

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The aim of this study was to identify the most relevant dental factors and iatrogenic causes in the development of pathological changes to the sinus membrane and to analyse their possible influence on the development of odontogenic sinusitis. A descriptive, observational study was designed, with 276 patients who had been evaluated via cone beam computed tomography, analysing possible sinus thickening factors, such as apical infections, endodontic treatments, periodontitis, radicular cysts and impacted teeth, as well as iatrogenic factors caused by implant treatments or the development of oroantral communications produced during tooth extraction manoeuvres. Among the dental factors, periodontitis (47.1%), apical pathology (23.5%) and endodontic treatments (23.1%) were the predominant causes of sinus membrane thickening that most frequently produced an occupancy between 2 and 10 mm. Regarding the implant treatments, the placement of implants through the floor of the maxillary sinus was the main cause (9.8%), followed by sinus elevation techniques (6.2%). Dental extraction was the first cause of oroantral communication (5.0%), being the procedure that caused the greatest thickening of the sinus membrane. This study highlights the importance of dental treatments and iatrogenic factors in sinus pathology, and the need for diagnostic interrelations between the different specialists who address this pathology.

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Section: Discussionmentioning

confidence: 99%

Analysis of the Radiological Changes of the Sinus Membrane Using Cone Beam Computed Tomography and Its Relationship with Dental Treatments. A Retrospective Study

Rey-Martínez¹,

Ruiz-Sáenz

Martínez-Rodríguez

et al. 2022

Biology

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“…A final interesting point relates to sinus surgery extent in ODS patients undergoing ESS. While most studies to date have described opening all diseased sinuses based on preoperative imaging, 13,14,35,37,38 two prospective series from a single institution have demonstrated success with maxillary antrostomy alone in uncomplicated ODS patients even with frontal sinus involvement 47,48 . Additionally, the recent ODS management consensus statement did not reach consensus on one item pertaining to ESS extent for uncomplicated ODS.…”

Section: Managing Odsmentioning

confidence: 99%

“…While most studies to date have described opening all diseased sinuses based on preoperative imaging, 13 , 14 , 35 , 37 , 38 two prospective series from a single institution have demonstrated success with maxillary antrostomy alone in uncomplicated ODS patients even with frontal sinus involvement. 47 , 48 Additionally, the recent ODS management consensus statement did not reach consensus on one item pertaining to ESS extent for uncomplicated ODS. For uncomplicated ODS (i.e., no extrasinus spread), it was agreed that maxillary antrostomy alone is an option, regardless of sinusitis extent, but opening all diseased sinuses is also reasonable.…”

Section: Managing Odsmentioning

confidence: 99%

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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“…On the other hand, patients with severe symptoms or orbital/intracranial complications should be treated with a combined approach right from the diagnosis, thus allowing for sinus drainage and resolution of the etiological dental focus. While endoscopic sinus surgery has an undebated role in ODS treatment, the extent of said surgery is still a matter of debate, since some authors 19,20 proposed that middle antrostomy is enough to warrant patient healing. While prospective validation of these approaches is required, at present opening all sinuses involved in ODS [21][22][23] , while being the most frequent approach, is recommended only in case of ODS with orbital or intracranial complications 9 .…”

Section: General Principles Of Ods Treatmentmentioning

confidence: 99%