Treatment Of Odontogenic Maxillary Sinusitis Research Articles

Effect of severe periodontitis of maxillary molars on the maxillary sinus and the treatment principles of periodontitis related maxillary sinusitis

Maxillary sinus is located in the maxilla bone with the largest volume in all sinuses and is closest to the roots of maxillary posterior teeth, especially the mesiobuccal root of the maxillary second molar. The thickness of the normal maxillary sinus mucosa is about 1 mm. When stimulated or infected, it shows thickening of the mucosa. Periodontitis is one of the most common oral diseases in human beings, and the complex root anatomy of the maxillary molars aggravates the difficulty of inflammation control. Severe periodontitis of maxillary molars without effective treatment can affect the maxillary sinus, increasing the possibility of the mucosa thickening, and is also one of the reasons for the occurrence of odontogenic maxillary sinusitis (OMS). There are many different schemes for the treatment of OMS caused by severe periodontitis of maxillary molars. Extraction of teeth with severe periodontal disease without retention value or successful periodontal treatment can significantly reduce the thickness of maxillary sinus mucosa. For the patients with uncontrollable sinusitis by using drug treatment and eliminating odontogenic causes, or ones with severe symptoms, periodontal treatment and endoscopic sinus surgery can be combined to effectively control the periodontitis related maxillary sinusitis.

Analysis on the relationship between Schneiderian membrane thickening in the posterior maxillary region and periapical lesions by cone beam computed tomography.

This study aimed to evaluate the thickening of sinus membrane, which is also named Schneiderian membrane (SM), in patients and its relationship with periapical lesions (PAL) in the posterior maxillary region to provide reference for the prevention and treatment of odontogenic maxillary sinusitis. A retrospective analysis was conducted on 554 cone beam computed tomography (CBCT) imaging data of maxillary sinuses from 301 patients who met the inclusion criteria to determine the correlation between PAL and SM thickening in the posterior maxillary region. Cases of pathological SM were recorded and classified on the basis of the degree and type of SM thickening. The correlation between SM thickening and the diameter of PAL, the relationship between the upper edge of PAL and the maxillary sinus floor, and its relationship with whether affected teeth with PAL undergo root canal treatment were evaluated. The detection rate of SM thickening in patients with PAL was significantly higher than in those without PAL, so PAL was correlated with SM thickening. Analysis on the correlation between PAL detection indicators and SM thickening degree showed that SM thickening degree was positively correlated with PAL diameter (cone beam computed tomography-periapical index) and not correlated with the three spread effects between the upper edge of PAL and the maxillary sinus floor, as well as whether the teeth with PAL undergo root canal treatment. The correlation analysis between PAL detection indicators and SM thickening types showed that whether the teeth with PAL undergo root canal treatment was not correlated with SM thickening types, and the diameter of PAL, the three spread effects between the upper edge of PAL, and the maxillary sinus floor were not correlated with SM thickening types. The PAL of posterior maxillary teeth is closely related to SM thickening, and the diameter of PAL is positively correlated with the degree of SM thickening. Patients with PAL who have undergone root canal treatment often exhibit SM polyp thickening. In addition, the relationship between the upper edge of PAL and the maxillary sinus floor does not affect the possibility of SM development.

Surgical Endoscopic Treatment of Odontogenic Sinusitis.

Introduction: Odontogenic sinusitis is a frequent disease of the maxillary sinus, resulting from a dental inflammatory condition or a foreign body migrated in the sinus cavity. We performed a clinical retrospective study aimed to review the two surgical endoscopic approaches for odontogenic maxillary sinusitis middle and inferior meatotomy, in terms of realistic indications, efficacy, outcomes, and possible complications. Materials and Methods: In our study, we included a number of 400 patients with odontogenic maxillary sinusitis divided into two groups, treated in our hospital over five years, from January 2019 to December 2023. The patients included in this research were over 18 years old, diagnosed with odontogenic maxillary sinusitis, and underwent either middle meatal antrostomy or inferior meatotomy. Results: We examined the medical records of 400 patients. The vast majority of patients had a history of dental interventions, and the most affected tooth was the first maxillary molar. The symptoms at admission were typical for sinusitis: nasal obstruction, anterior or posterior rhinorrhea, hyposmia to anosmia, cacosmia, and pain or facial pressure. 80% of the patients in the study underwent middle meatal antrostomy, while 20% underwent inferior meatotomy. There were no significant differences between these two approaches in terms of efficacy, complication rates, recovery, or relapses. The complications that occurred after the surgical treatment were minor and with a very low frequency. The most reported were middle meatus synechiae and the persistence of the meatotomy ostium, with mucus recirculation (in patients with inferior meatotomy). Conclusions: Endoscopic surgical treatment of odontogenic maxillary sinusitis can be done as middle or inferior meatotomy, each having specific indications. The maxillary antrostomy is preferred in the majority of cases, as it is a procedure in which the natural ostium of the maxillary sinus is enlarged, thereby maintaining the natural drainage pathway of the sinus. However, the inferior meatotomy is preferred in the case of foreign bodies or maxillary sinus retention cysts localized at the level of the sinus floor or in the alveolar or lateral recesses, or as part of a combined approach (inferior and middle meatotomy), when the ablation of a "fungus ball" is required.

Factors Influencing Recurrence after Surgical Treatment of Odontogenic Maxillary Sinusitis: An Analysis from the Oral and Maxillofacial Surgery Point of View.

The aim of the study was to determine the factors influencing the development of recurrence after the surgical treatment of odontogenic maxillary sinusitis in an oral and maxillofacial surgery clinic over a 7-year period. Demographic and anamnesis data, clinical and radiological findings, treatment and outcome were analyzed. A multivariable analysis was performed to find associations between patient age, causative focus, surgical access for sinus revision, multilayer closure with a buccal fat pad, inferior meatal antrostomy (IMA) for temporary sinus drainage and sinusitis recurrence. A total of 164 patients with a mean age of 51.7 years were included. Sinusitis recurrence was observed in nine patients (5.48%) within 6 months after primary surgery. No significant correlation was detected between patient age, causative focus, surgical access for sinus revision, multilayer closure with a buccal fat pad, IMA for sinus drainage and the development of recurrence (p > 0.05). Patients with a history of antiresorptive-related osteonecrosis of the jaw showed a significant tendency toward disease recurrence (p = 0.0375). In conclusion, except for antiresorptive administration, none of the investigated variables were related to a higher risk of sinusitis recurrence. We encourage a combined approach of intraoral removal of the infective focus and sinus drainage via FESS, as well as an individual treatment decision in a multidisciplinary setting with collaboration between dentistry, maxillofacial surgery and otorhinolaryngology to avoid sinusitis recurrence.

Surgical Approach to Odontogenic Maxillary Sinusitis Caused by Tooth Root Displacement into the Maxillary Sinus: A Case Report

Paranasal sinuses affected by foreign bodies are uncommon clinical situations. Foreign body displacement into facial sinuses is a potential iatrogenic complication, that may cause an oroantral fistula, sinusitis, cellulitis, and subdural emphysema. The maxillary sinus is usually the most affected by tooth displacements, due to its proximity. A dental fragment in the maxillary sinus may cause Odontogenic Maxillary Sinusitis (OMS). The present case report presents a case from the diagnosis to treatment of OMS originated by a fragment of tooth root displacement into the sinus during a previous dental extraction. A female patient, 13-yearold, had characteristic signs of sinusitis, reporting rhinorrhoea, headache, eye pain, and pain on the left side of the face. The clinical examination showed pain on palpation in the buccal region of the upper left first molar, which was absent. The Cone Beam Computed Tomography (CBCT) showed a foreign body inside the maxillary sinus, complete opacification, and bone defect on the sinus floor. Given the final diagnosis of OMS, the treatment selected was the combination of antibiotic therapy and fragment removal from the sinus. The diagnosis, planning, and correct use of surgical techniques described in the literature are essential for preventing iatrogenesis and actively ensuring patient health. In this sense, patients need to be informed about any complication, which should be written in the medical records along with resolution measures.

Modern approach for complex treatment of odontogenic maxillary sinusitis

Introduction: Odontogenic maxillary sinusitis is associated with diseases of the maxillary teeth. The close anatomical relationship of these teeth with the floor of the maxillary sinus leads to violation of the integrity of its mucosa and creates prerequisites for the infection to pass into the sinus cavity. Odontogenic maxillary sinusitis is characterized by dental complaints and the typical symptoms of all rhinosinusitis. There is lack of consensus in the literature on the algorithm of behaviour in these cases. Aim: To recommend a contemporary algorythm of management in patients with odontogenic maxillary sinuitis, which is consistent with both the established rules for the treatment of rhinosinusitis and the individual characteristics of each clinical case. Materials and methods: For the period 2001-2021, 157 patients were treated at St. George University Hospital, after extraction of an upper tooth (4-6) or with symptoms of nasal breathing difficulties and unilateral whitish secretion with an unpleasant odour. All of them had a history of dental intervention and CT data for changes in the osteomeatal complex or „foreign bodies“ in the maxillary sinus. Results: All patients were discharged on the third day after admission in improved general condition without complaints. No late postoperative complications were observed. In 8 of the patients with sinuscopy, after the control CT examination, performed a month later, a second intervention was necessary for the extraction of residual fungal material. Conclusion: The treatment of odontogenic maxillary sinusitis involves interdisciplinary approach of otorhinolaryngologists and dental specialists. However, modern understanding of the functioning of the nasal cavities and the development of pathological processes in them help us to build and present an adequate concept for diagnosis and therapeutic behavior.

Relationship between infected tooth extraction and improvement of odontogenic maxillary sinusitis

ObjectiveOdontogenic maxillary sinusitis (OMS) is a well‐recognized disease in otolaryngology and oral and maxillofacial surgery. It is diagnosed comprehensively based on the presence of dental disease and radiographic evaluation. Although the disease involves a combination of dental and otorhinolaryngological features, appropriate criteria have not been well established for prioritizing dental procedures in the initial treatment of OMS. We investigated whether computed tomography (CT) score, including the Lund–Mackay score, can help prioritize tooth extraction as the initial treatment for OMS.MethodsWe also investigated the radiographic features of 32 patients with OMS treated by tooth extraction alone. Both pre‐and post‐extraction CT images of OMS cases were evaluated.ResultsLund–Mackay scores before tooth extraction were significantly lower in postoperatively healed patients than in non‐healed patients. Furthermore, CT scores of the anterior and posterior ethmoid sinuses and frontal sinuses, obtained before tooth extraction, were significantly lower in postoperatively healed patients than in non‐healed patients.ConclusionsCollectively, low Lund–Mackay and CT scores of the ethmoid and frontal sinuses are significantly associated with healing of OMS treated by tooth extraction alone. The sinus CT score can help identify a treatment strategy for OMS.

ROLE OF QUALITATIVE ENDODONTIA IN THE SCHEME OF INTERDISCIPLINARY TREATMENT OF MAXILLARY ODONTOGENIC SINUSITIS

In the treatment of odontogenic maxillary sinusitis, the removal of causative teeth is actively used, although the tooth removal indications are not always clearly defined. Modern endodontic approaches and technologies, in most cases, help preserve the tooth in the oral cavity with the elimination of the chronic infection focus, thus restoring the integrity of the maxillary sinus.
 Background. Improve the effectiveness in the treatment of odontogenic maxillary sinusitis while preserving the causative teeth.
 Materials and methods. The study involved 50 patients aged 18 to 45 years. All patients had clinical signs of maxillary odontogenic sinusitis and signs of failed endodontic treatment of teeth with a dark, radiolucent focus in the apex region. Radiological parameters and quality of obturation was assessed using CBCT; the presence of symptoms of inflammation was assessed clinically during examination. The results were evaluated after 6, 12 and 24 months. The treatment effectiveness and the quality of obturation was assessed in accordance with the directives of the European Society of Endodontology.
 Results. High-quality endodontic treatment resolved clinical signs of odontogenic sinusitis in all patients, restored the bone tissue of the alveolar process and restored the mucous membrane of the maxillary sinus after 12 months in 96% of cases. In 2 cases, additional microsinusotomy was required.
 Conclusion. Improving the quality of endodontics in the first treatment or retreatment of the upper jaw teeth can significantly reduce the number of dental extractions in odontogenic maxillary sinusitis

Treatment of Odontogenic Maxillary Sinusitis

Treatment of Odontogenic Maxillary Sinusitis

New Insight on Pathophysiology, Diagnosis, and Treatment of Odontogenic Maxillary Sinusitis

Odontogenic maxillary sinusitis is often ignored by otolaryngologists, dentists, and imageological diagnosis doctors. Traditional treatments are often frustrating for refractory maxillary sinusitis and odontogenic maxillary sinusitis. In the last few years, new progress has been made in the diagnosis, pathophysiology, and treatment of odontogenic maxillary sinusitis. Periodontitis, polyposis, and iatrogenesis are regarded as causes of odontogenic maxillary sinusitis. Dental implant dislocation into the maxillary sinus and augmentation are the main cause of iatrogenesis compared to root canal full material. The symptoms are too similar to distinguish odontogenic maxillary sinusitis from chronic rhinosinusitis. Computed tomography is the gold standard for diagnosis, while it is difficult to rule out odontogenic maxillary sinusitis by conventional panoramic radiographs. Cone-beam computed tomography (CBCT) is currently the most broadly used to make diagnosis and differential diagnosis for maxillary sinus disease. The imaging diagnosis, clinical diagnosis, and pathological diagnosis are often not completely in accordance. Most researchers believe that odontogenic maxillary sinus infection results from the spread of apical pathogenic microbial infections: either through the local vascular system, lymphatic system, or the Haval system of the alveolar bone itself. DNA and RNA sequencing of mucosal tissues of maxillary sinus disease confirmed that the mechanisms of odontogenic maxillary sinusitis and nonodontogenic maxillary sinusitis are different. Microbial RNA sequencing of the maxillary sinus also verifies this conclusion. Clinical serum testing of chemical factors has not been widely exploited. It is unknown whether the thickening of the maxillary sinus membrane is the result of pathogen infection or inflammatory mediators. Many doctors have recommended a consensus on multidisciplinary cooperation management, but a global consensus has not yet been reached. Diagnosis methods for odontogenic maxillary sinus disease are diversified. Tissue DNA and RNA sequencing, chemical factor determination, and microbiological DNA and RNA sequencing have appeared, and the misdiagnosis rate has gradually decreased. The pathophysiology of odontogenic maxillary sinusitis and chronic rhinosinusitis is different. The molecular mechanism of the thickening of the Schneider membrane in odontogenic sinus is unknown.

CT scan evaluation of the distance between maxillary sinus floor and maxillary teeth apices

Abstract BACKGROUND. The relationship between the maxillary sinus floor and the roots of the teeth in the upper arch is essential, especially in the correct diagnosis and treatment of odontogenic maxillary sinusitis. The aim of this study was to determine exactly this distance and to observe the most common teeth situated closely to the maxillary sinus. MATERIAL AND METHODS. The study was performed in 2020, in the ENT Department of “Sfanta Maria” Hospital, and was made based on computed tomography (CT) scans of the sinuses from the clinic’s archive. The image analysis was performed with a radiologic software. For each tooth, from both right and left upper hemiarcade, the distance between the dental root and the bony floor of the maxillary sinus was measured and the average distances were compared. RESULTS. Among the present teeth analysed, those with the closest distance were the 1st M (95.15% on the right side and 96.23% on the left side), then the second molars (96.08% on the right side and 90% on the left side). The 2nd and 3rd PM had a similar percentage of the sinusal approach, which varied between 82% and 86%. CONCLUSION. Knowing these dento-sinusal relationships, there is a win-win situation for both the ENT doctor and the dentist. The paraclinical examination necessary for the analysis of the dento-alveolo-sinusal relation and of the afferent pathology is the imaging one, of choice being the CT and CBCT scans.

Single-step surgical treatment of odontogenic maxillary sinusitis: A retrospective study of 98 cases

PurposeThe aim of this study was to review clinical and radiological presentation, surgery, and results of treatment in patients with chronic odontogenic maxillary sinusitis (OMS) treated with a single surgical procedure, including endoscopic sinus surgery (ESS) and oral surgical approaches to treat the odontogenic source of infection. Materials and methodsA retrospective case series analysis of 98 patients was performed. All the patients received ESS. 88 patients required oral surgical approaches. ResultsNasal symptoms were present in 58 patients (59.2%). Nasal endoscopy was positive in 65 patients (66.3%). A positive nasal endoscopy was significantly associated with nasal symptoms (p < 0.05). 60 patients (61.2%) had OMS of iatrogenic origin. Total opacification of the maxillary sinus was the most common radiological presentation (74.5%) and was significantly associated with nasal symptoms (p < 0.05). 91 patients (92.9%) had complete clinical and radiological resolution of the OMS. ConclusionsIatrogenic origin, sinonasal symptoms and positive clinical endoscopy are common in patients with OMS. Nasal symptoms were significantly associated with total maxillary sinus opacification and positive endoscopic clinical examination. Combining treatment of the odontogenic source of infection via an oral surgical approach and of the sinus inflammation by ESS appears to be sufficient for successfully treating patients with OMS.

Методика периоперационного лечения одонтогенного верхнечелюстного синусита: практическое применение

The problem of treatment of odontogenic maxillary sinusitis lies at the interface of two specialties – otorhinolaryngology and dentistry. Dental manipulations in the area of large molars of the upper jaw, performed in violation of the guidelines of treatment of tooth hard tissue pathology, may result in the development of odontogenic maxillary sinusitis. A damage of the lower wall and mucous membrane of the maxillary sinus is not always properly assessed by dentists. In such cases, it is necessary to involve an otorhinolaryngologist to determine the further treatment approach. To improve the quality of care of patients with odontogenic maxillary sinusitis, the development of an integrated approach in the treatment of odontogenic maxillary sinusitis by both dentist and otorhinolaryngologist is a relevant and promising direction. The article suggests a new method of odontogenic maxillary sinusitis treatment based on interdisciplinary approach, used in the Clinic of Otolaryngology of the Military Medical Academy. The authors present clinical cases of odontogenic maxillary sinusitis, in which this technique was applied. Different variants of the course of odontogenic maxillary sinusitis called for simultaneous participation of an otorhinolaryngologist and maxillofacial surgeon. Joint examination, high-quality X-ray diagnosis, precise determination of the cause, regular interaction at different stages of treatment, determination of indications and contraindications to surgery provide a new look at the clinical outcome of odontogenic maxillary sinusitis.

A Cross-Sectional Survey on the Diagnosis and Treatment of Odontogenic Maxillary Sinusitis by Otorhinolaryngologists and Dentists

A Cross-Sectional Survey on the Diagnosis and Treatment of Odontogenic Maxillary Sinusitis by Otorhinolaryngologists and Dentists

Odontogenic maxillary sinusitis: current state of the problem

Odontogenic maxillary sinusitis is a problem that is at the junction of two specialities: otorhinolaryngology and dentistry. According to domestic and foreign authors in the structure of dental diseases, odontogenic maxillary sinusitis is6-24%. According to doctors-otorhinolaryngologists among all types of sinusitis about 40% is odontogenic maxillary sinusitis. Currently, there is a gradual increase in the number of odontogenic maxillary sinusitis. This is due to the improved diagnosis of this pathology. The use of dental computed tomography usually allows establishing reliably the cause of odontogenic maxillary sinusitis. Unsatisfactory results of treatment of some dental diseases, the increase in the number of odontogenic maxillary sinusitis determines the relevance of the study. The problem of odontogenic maxillary sinusitis is considered, modern views on the aetiology, pathogenesis, clinic, diagnosis and treatment according to domestic and foreign authors, as well as some issues of the relationship of pathology of intraosseous structures and the course of odontogenic maxillary sinusitis, the principles of an interdisciplinary approach in the treatment of odontogenic maxillary sinusitis are presented. The search for new methods of treatment of odontogenic maxillary sinusitis is dictated by some differences in clinical manifestations of odontogenic sinusitis from rhinogenic. The approach based on the joint primary examination and treatment of patients with suspected odontogenic maxillary sinusitis by an otorhinolaryngologist and maxillofacial surgeon, as well as the development of further tactics for the management of this category of patients, is, in our opinion, promising. The use of modern methods of functional endoscopic surgery is an effective means of prevention and treatment of odontogenic maxillary sinusitis, as it is a minimally invasive technique that allows you to create conditions for further rational prosthetics of the oral cavity.

Endoscopic sinus surgery plays an essential role in systematic treatment of odontogenic maxillary sinusitis

PurposeOdontogenic maxillary sinusitis (OMS) is frequently encountered in otorhinolaryngologists' clinical practice. Endoscopic sinus surgery (ESS) instead of surgeries in intraoral approach has been widely applied among OMS. However appropriate treatments due to the causes of the OMS as well as the outcome have been less investigated, meanwhile the inherent incidence of OMS may be still on the rise. This study was designed to conclude our systematic treatment within follow-up examination. Materials and methodsIn this retrospective study patients confirmed diagnosis of OMS who had systematic follow-up examinations were analyzed. Medical histories of otorhinolaryngologists and dentists were reviewed as well as preoperative examination protocols. ResultConsecutive 29 Patients (10 women, 19 men) were included. 41.4% (12/29) patients experienced facial pain as the most frequent symptom. 69.0% (20/29) patients admitted firstly to otorhinolaryngologists, 13 patients were treated with surgical procedure while 7 patients lacking of surgical indication were transferred to dentists. 31.0% (9/29) patients were advised by dentist for being suspected of maxillary sinusitis, including 7 patients suffered from sinonasal complications of dental treatment (SCDT). Conventional dental treatment (root planning, root end surgery, extraction) was the most common cause. Follow up for a mean of 15.1 (ranges from 6 to 96) months showed 29 patients maintaining open maxillary ostium on endoscopic examination or improving on CT except recurrence in one patient with SCDT. ConclusionPatients should be inspected by dentists carefully when the patient has symptoms rather than sinusitis-like symptoms, the possibility of OMS should always be considered. Dental examination can help to determine whether a maxillary sinusitis has a dental origin, periodontitis and odontogenic radicular cysts still are the most common causes comparing with iatrogenic factors. Patients treated with ESS showed better tolerance and fewer postsurgical complications. Not all patients with OMS including SDCT need definitely surgery whether ESS or intraoral approach, removing dental focus followed with antibiotics would be optimistic choice.

Endoscopic antrostomy in the treatment of odontogenic maxillary sinusitis - two cases report

Introduction. Maxillary sinusistis of odontogenic origin is a wellknown condition that occurs due to close relationship of the maxillary posterior teeth to the maxillary sinus. We presented two patients with symptoms and signs of chronic inflammation of the maxillary sinus of odontogenic origin. Case report. In both patients, after clinical examination, microbiological testing, skin prick tests to inhalant allergens, and endoscopy of the nasal cavity, we performed the cone beam computed tomography (CBCT) of paranasal sinuses, which showed thickening of the mucosal lining of the maxillary sinus. The mucosal oedema resulted in obstruction of the osteomeatal complex in both patients. The presence of a foreign body in the right alveolar recess in the first case and in the left osteomeatal complex in the second case were noticed. The both foreign bodies had densities similar to bone. The alveolar recesses in both cases were below the level of the nasal cavity floor. The patients were treated by endoscopic approach, a combination of lower and middle meatal antrostomy. The thickened mucous membrane was removed in the region of the osteomeatal complex, and then the foreign bodies were removed in both cases. Histopathological analysis proved that both foreign bodies were tooth roots. Conclusion. This case report show how be able to successfully surgically remove foreign bodies from the maxillary sinuses using endoscopic approach, a combination of both, lower and middle meatal antrostomy.

The experience with the application of a lyophilized xenodermograft for the treatment of the patients suffering from frequently recurring inflammation of the maxillary sinus in combination with alveolar fistula

The objective of the present study was to summarize the data of the special literature concerning methods of the surgical treatment of odontogenic maxillary sinusitis complicated by the alveolar fistula with the purpose of using them for the improvement of the effectiveness of the treatment of the patients presenting with this pathology. The study group was comprised of 39 patients with odontogenic diseases of paranasal sinuses and alveolar fistulas. The alveolar fistulas were closed in 20 patients by means of plastic surgery with the use of a lyophilized xenodermograft prepared from the pig's skin. Not a single case of relapse of the inflammatory process in the maxillary sinuseswas documented within one year after the treatment by means of the closure of the alveolar fistula using the lyophilizedxenodermografts.

Aperture width of the osteomeatal complex as a predictor of successful treatment of odontogenic maxillary sinusitis

Odontogenic maxillary sinusitis (OMS) is an inflammatory disease caused by the spread of dental inflammation into the sinus. The long-term administration of antibiotic medicine and/or treatment of the causative tooth are the usual initial treatments. These initial treatments are not always effective, and the reason is not well understood. The purpose of this study was to identify factors of significance that may contribute to the results of the initial treatment of OMS. Thirty-nine patients were studied, divided into two groups according to the results of initial treatment: effective or non-effective. The effective group comprised 20 patients who were cured by initial treatment. The non-effective group comprised 19 patients who required an additional operation. The duration of symptoms, spread into the other sinuses, aperture width of the osteomeatal complex (OMC) on the side of the maxillary sinus, and anatomical variations in the sinuses were compared between the groups. The only significant difference found was in the aperture width of the OMC, which was significantly narrower in the non-effective group than in the effective group. The aperture width of the OMC may be a significant predictor of the effectiveness of initial treatment of OMS.

Caldwell-Luc Operation Without Inferior Meatal Antrostomy: A Retrospective Study of 50 Cases

In the standard Caldwell-Luc operation, an inferior meatal antrostomy is performed to promote sinus drainage. However, inferior meatal antrostomy has been criticized for its additional operation time and wound, early loss of the opening, and risk of injury to the nasolacrimal duct. This study retrospectively reviewed the results of the Caldwell-Luc operation without inferior meatal antrostomy in the treatment of odontogenic maxillary sinusitis or odontogenic sinus disease. The records of 50 patients who had an odontogenic sinus disease and underwent the Caldwell-Luc operation without inferior meatal antrostomy were reviewed. The data included the patient's age, gender, surgical indications, surgical condition, and complications. From April 2004 to October 2010, there were 27 male patients and 23 female patients aged 14 to 70 years (mean, 37 years) who underwent the modified Caldwell-Luc operation. The surgical indications included intrasinus odontogenic cysts (44%), oroantral fistulae with chronic sinusitis (44%), odontoma (4%), odontogenic sinusitis (4%), and foreign bodies in the maxillary sinus (4%). The patients were successfully treated with minimal complications. The modified Caldwell-Luc operation provides easier postoperative care and involves fewer complications. It is not necessary to create the inferior meatal antrostomy in the Caldwell-Luc operation when treating odontogenic sinus disease.