Role of Endoscopic Sinus Surgery and Dental Treatment in the Management of Odontogenic Sinusitis Due to Endodontic Disease and Oroantral Fistula.

Silviu Albu,Dan Valean,Corneliu Toader,Veronica Elena Trombitaș,Anda Gâta

doi:10.3390/jcm10122712

Silviu Albu, Dan Valean + Show 3 more

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https://doi.org/10.3390/jcm10122712

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Abstract

Background: Odontogenic sinusitis (ODS) is frequently encountered in ENT practice; however, there are no guidelines regarding its management. This study aims to analyse the results of endoscopic sinus surgery versus dental treatment in ODS. Additionally, we aim to demonstrate the benefit of associating endoscopic sinus surgery (ESS) to surgical closure of chronic oroantral fistulas (OAF) by comparing mean time to healing in patients who opted or not for concurrent ESS. Methods: Records of patients with ODS were reviewed. Group one consisted of patients with ODS caused by periapical pathology undergoing either endoscopic sinus surgery (ESS) or dental treatment. Resolution of ODS was considered treatment success and was compared between the two treatment strategies. Group two included patients with ODS and associated chronic oroantral communication. Time to healing was compared between patients undergoing OAF closure alone versus patients receiving associated ESS, using the Log-Rank test to correlate Kaplan–Meier curves. Results: 25 patients from a total of 45 in group one underwent dental treatment alone, and 20 opted for exclusive ESS treatment. The failure rate was 40% for patients treated with ESS compared to 4% (one patient) for dental treatment. ODS resolved in all patients in the second group, but the mean time to healing was half (10 days) when ESS was complementary to OAF closure. Conclusion: The present study represents the first estimator of the role ESS plays in OAF treatment. Nonetheless, it provides proof of the importance of first addressing dental problems in odontogenic sinusitis.

Highlights

Odontogenic sinusitis (ODS) represents maxillary sinusitis, with possible extension to other sinuses, caused by the spread of adjacent dental pathology or resulting from trauma and oral procedures [1]
Exclusion criteria consisted of chronic rhinosinusitis with nasal polyps, sinonasal malignancy, previous sinus surgery, ODS associated with implants, trauma, oroantral communications and with sinus foreign bodies
Results agnosed with unilateral odontogenic sinusitis caused by dental disease, and 31 patients

Summary

Introduction

Odontogenic sinusitis (ODS) represents maxillary sinusitis, with possible extension to other sinuses, caused by the spread of adjacent dental pathology or resulting from trauma and oral procedures [1]. Ferguson and Longhini [8] reviewed 85 sinusitis guidelines, and 11 mentioned ODS, but none gave guidance regarding treatment of this frequent pathology. This study aims to analyse the results of endoscopic sinus surgery versus dental treatment in ODS. We aim to demonstrate the benefit of associating endoscopic sinus surgery (ESS) to surgical closure of chronic oroantral fistulas (OAF) by comparing mean time to healing in patients who opted or not for concurrent. ODS caused by periapical pathology undergoing either endoscopic sinus surgery (ESS) or dental treatment. Group two included patients with ODS and associated chronic oroantral communication. Time to healing was compared between patients undergoing OAF closure alone versus patients receiving associated ESS, using the Log-Rank test to correlate Kaplan–Meier curves

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