Redefining boundaries in odontogenic sinusitis: a retrospective evaluation of extramaxillary involvement in 315 patients

Saibene, Alberto Maria; Pipolo, Carlotta; Lozza, Paolo; Maccari, Alberto; Portaleone, Sara Maria; Scotti, A.; Borloni, Roberto; Messina, Francesco; Pasquale, Daniele Di; Felisati, Giovanni

doi:10.1002/alr.21400

Cited by 51 publications

(42 citation statements)

References 17 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%

“…Sinonasal symptoms of ODS are consistent with cardinal symptoms of acute and chronic sinusitis, 7 although ODS symptoms are more commonly unilateral. 6,13,[15][16][17] Anterior and posterior nasal drainage are most frequently reported in ODS in 60% or more of patients. 6,15,16,18 Some series have reported foul smell or taste in 50% to 84% of ODS cases, 6,18 whereas other series have reported foul smell or taste in a minority of cases.…”

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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“…As a result, clinicians should carefully analyze maxillary dentition when interpreting maxillofacial CT scans, particularly in the setting of unilateral maxillary sinusitis . Furthermore, involvement of the ostiomeatal unit may result in extension to adjacent paranasal sinuses with reported rates of extramaxillary extension ranging from 27% to 60% among patients with odontogenic sinusitis . In addition, as many as 20% of patients with odontogenic sinusitis may have bilateral involvement .…”

Section: Introductionmentioning

confidence: 99%

Odontogenic sinusitis: A review of the current literature

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Loehrl

et al. 2018

Laryngoscope Investig Oto

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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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“…Dental treatments causing fungus balls range from dental reconstruction to tooth extraction and more frequently endodontic treatment. In all these cases, the final pathway is represented by the onset of an odontogenic sinusitis that, first, it is confined to maxillary sinus, than it can spread to other paranasal sinuses, particularly to ethmoidal one and even contralaterally 4. It is nevertheless useful to remember that non-odontogenic fungus balls do exist, but their prevalence is unknown and it is not clear how thoroughly the dental history of the patient has been evaluated.…”

Section: Discussionmentioning

confidence: 99%

“…Anatomical modification of this region could therefore be considered the key in spreading the maxillary odontogenic infection to other sinuses: in fact, the ethmoid sinuses are involved in 59.7% of odontogenic disease 4 6 18…”

Section: Discussionmentioning

confidence: 99%

Unusual case of bilateral maxillary fungus ball

et al. 2016

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An otherwise healthy 34-year-old man was referred to our ear, nose and throat (ENT) clinic for a bilateral maxillary radiologic opacity. This condition was accidentally discovered with a panoramic radiography performed during a follow-up visit after a bilateral endodontic treatment. The patient did not report any specific sinonasal symptom such as purulent nasal discharge, loss of smell and cough, apart from an unspecific sinus pressure. The CT scans showed a bilateral inflammatory process into the maxillary-ethmoidal sinuses and an iron-like density within the maxillary sinuses, while nasal endoscopy showed purulent discharge in the ostiomeatal complex. The patient underwent functional endoscopic sinus surgery under general anaesthesia and the inflammatory material collected was histologically diagnosed as a rare case of bilateral fungus ball. The patient was dismissed the following day with no complications; there were not any sign of recurrence or symptoms during a 4 month follow-up.

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Redefining boundaries in odontogenic sinusitis: a retrospective evaluation of extramaxillary involvement in 315 patients

Cited by 51 publications

References 17 publications

Optimal timing of endoscopic sinus surgery for odontogenic sinusitis

Optimal timing of endoscopic sinus surgery for odontogenic sinusitis

Odontogenic sinusitis: A review of the current literature

Unusual case of bilateral maxillary fungus ball

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