Treatment and outcome of maxillary sinusitis associated with maxillary medication-related osteonecrosis

Abstract

ObjectivesMedication-related osteonecrosis of the jaw (MRONJ) of the maxilla often accompanies maxillary sinusitis. This study aimed to investigate the treatment and outcome of maxillary sinusitis associated with maxillary MRONJ. MethodsThis is a retrospective observational study. Among 68 patients with MRONJ of the maxilla undergoing surgical treatment at two university hospitals between 2012 and 2018, 31 patients with accompanying maxillary sinusitis were enrolled in the study. The relationship between treatment method and outcome of maxillary sinusitis was analysed by one-way ANOVA and Fisher’s exact test, as well as multivariate logistic regression analysis. ResultsAll patients underwent resection of the necrotic bone. As for treatment of maxillary sinusitis, 12 patients underwent antral lavage, 4 patients underwent endoscopic sinus surgery (ESS), and 15 patients received no maxillary sinus surgery. All 4 patients who underwent ESS achieved healing, and of the 12 patients who underwent antral lavage, 4 were healed, and 6 improved. However, out of the 15 patients who underwent removal of necrotic bone, but no maxillary sinus surgery, 8 showed no change or became worse. Patients who underwent antral lavage or ESS showed significantly better treatment outcomes than those who underwent necrotic bone resection alone upon both univariate and multivariate analyses. ConclusionsOur results show that better treatment outcomes might be achieved by performing sinus lavage or ESS for MRONJ-related maxillary sinusitis.