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Auris, Nasus, Larynx Feb 2021The successful management of odontogenic maxillary sinusitis (OMS) involves a combination of medical treatment with dental surgery and/or endoscopic sinus surgery (ESS)....
OBJECTIVE
The successful management of odontogenic maxillary sinusitis (OMS) involves a combination of medical treatment with dental surgery and/or endoscopic sinus surgery (ESS). However, there is no consensus for the optimal timing of ESS. Although several studies have emphasized dental surgery as the primary treatment modality for OMS, there is recent evidence to suggest that ESS alone may be an effective treatment approach. The purpose of this study is to retrospectively investigate the pathophysiology of the current intractable OMS and the role ESS, especially ESS preceding dental treatment, plays in its pathophysiology.
METHODS
Ninety-seven adults (60 males and 37 females, 48 ± 12 years) who underwent ESS for intractable OMS were retrospectively examined.
RESULTS
In a great deal of the cases (85 cases, 87.6%), causative teeth of OMS were periapical lesions after root canal treatment (endodontics). The root canal procedures were not sufficient; hence, the root-canal-treated teeth had periapical lesions causing OMS. In postoperative nasal endoscopy and cone-beam CT scans for all patients, the natural ostiums and the membranous portions of the maxillary sinuses were enlarged and the ostiomeatal complexes remained widely open. The ventilation and drainage of all patients' maxillary sinuses seemed to be successfully restored. Temporary acute sinusitis recurrence after primary ESS for OMS was observed in 10 cases (11.8%) when the patients caught a cold. However, since the natural ostium and the membranous portion of the maxillary sinuses and the ostiomeatal complexes remained widely open, antibiotic administration alone without dental treatment cured the temporary acute sinusitis. Regarding the causative teeth (endodontic treated teeth), in 83 out of 85 cases (97.6%), causative teeth were able to be preserved with only antibiotic treatment and without dental retreatment. In two cases, extraction of the teeth was necessary because the teeth became mobile. Regarding the causative teeth after dental restoration, in 2 out of 2 cases (100%), causative teeth were able to be preserved with antibiotic treatment alone.
CONCLUSION
ESS is highly indicated for OMS requiring surgery. The treatment results of intractable OMS are exceptionally good once the ventilation and drainage of the maxillary sinus is successfully restored after surgery. Consequently, ESS can be considered the first-line therapy for intractable OMS caused by root canal treatment (endodontics) and dental restoration, followed by close dental follow-up and dental treatment when necessary.
Topics: Acute Disease; Adult; Aged; Cone-Beam Computed Tomography; Endoscopy; Female; Humans; Male; Maxillary Sinus; Maxillary Sinusitis; Middle Aged; Retrospective Studies; Tooth Diseases; Tooth, Nonvital
PubMed: 32763093
DOI: 10.1016/j.anl.2020.07.021 -
Journal of Endodontics Apr 2023The overall prevalence of maxillary sinusitis of odontogenic origin (MSOO) is still unknown. Therefore, this study aimed to determine the pooled prevalence of MSOO and... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
The overall prevalence of maxillary sinusitis of odontogenic origin (MSOO) is still unknown. Therefore, this study aimed to determine the pooled prevalence of MSOO and verify associations between different odontogenic conditions and MSOO.
METHODS
Six electronic databases and the gray literature were searched on August 25, 2022. Two independent reviewers selected observational studies reporting the prevalence of MSOO and associated conditions in adults. Studies that did not use computed tomography for diagnosis were excluded. The methodological quality of the studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Cross-Sectional Studies. Data were analyzed by proportion and association meta-analyses. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach.
RESULTS
Thirty-eight studies were included in the qualitative analysis and thirty-one in the meta-analyses. Only 12 studies (31.6%) fulfilled all items of the methodological quality checklist. Overall, the studies reported prevalence measures per maxillary sinus or patient. Thus, the pooled prevalence of MSOO was 51% per sinus (95% confidence interval [CI] [40%-61%]) and 50% per patient (95% CI [41%-59%]). Apical lesion (odds ratio [OR]: 4.03, 95% CI [2.26-7.19]), periodontitis (OR: 5.49, 95% CI [2.27-13.24]), moderate (OR: 2.57, 95% CI [1.85-3.57]) and severe bone loss (OR: 13.80, 95% CI [2.81-67.85] were significantly associated with MSOO. The certainty of the evidence for the associations was very low.
CONCLUSIONS
The pooled prevalence of MSOO on computed tomography assessment was 51% per maxillary sinus and 50% per patient. Therefore, half of the maxillary sinusitis may be of odontogenic origin. Apical lesion, periodontitis, and moderate and severe bone loss were significantly associated with MSOO.
Topics: Adult; Humans; Maxillary Sinusitis; Prevalence; Cross-Sectional Studies; Maxillary Sinus; Tomography, X-Ray Computed
PubMed: 36754253
DOI: 10.1016/j.joen.2023.01.010 -
Journal of Periodontal & Implant Science Dec 2019Maxillary implants are inserted in the upward direction, meaning that they oppose gravity, and achieving stable support is difficult if the alveolar bone facing the... (Review)
Review
Maxillary implants are inserted in the upward direction, meaning that they oppose gravity, and achieving stable support is difficult if the alveolar bone facing the maxillary sinus is thin. Correspondingly, several sinus-lifting procedures conducted with or without bone graft materials have been used to place implants in the posterior area of the maxilla. Even with these procedures available, it has been reported that in about 5% of cases, complications occurred after implantation, including acute and chronic sinusitis, penetration of the sinus by the implant, implant dislocation, oroantral fistula formation, infection, bone graft dislocation, foreign-body reaction, Schneiderian membrane perforation, and ostium plugging by a dislodged bone graft. This review summarizes common maxillary sinus pathologies related to implants and suggests an appropriate management plan for patients requiring dental implantation.
PubMed: 31886027
DOI: 10.5051/jpis.2019.49.6.346 -
The Journal of Craniofacial Surgery Oct 2022Posttraumatic chronic maxillary sinusitis deleteriously affects the life quality of patients with recurrent episodes and related discomfort. However, few studies have...
Posttraumatic chronic maxillary sinusitis deleteriously affects the life quality of patients with recurrent episodes and related discomfort. However, few studies have been performed to investigate the prevalence of chronic maxillary sinusitis after surgery of mid-facial fracture and related risk factors. The early prevention and cure of posttraumatic chronic maxillary sinusitis have received little attention. This study aimed to investigate the prevalence of chronic maxillary sinusitis after surgery for mid-facial fracture and to identify related risk factors. The authors retrospectively collected the medical history, radiographic examination, and clinical examination of patients with mid-facial fracture (experimental group) and patients with mandibular cyst (control group) in our department between January 2015 and December 2020. A total of 298 patients (416 maxillary sinuses) in the experimental group and 172 patients (344 maxillary sinuses) in the control group were included for analyses. The prevalence of chronic maxillary sinusitis in the experimental group and control group were, respectively, 9.14% and 2.04% ( P < 0.05). History of sinusitis/rhinitis (odds ratio = 63.70, P = 0.000) was an independent risk factor for posttraumatic chronic maxillary sinusitis. In conclusion, these findings showed that the prevalence of chronic maxillary sinusitis after surgery for midfacial fracture was significantly higher than that in the control group and long-term follow-up may be beneficial for these patients. Moreover, patients with a history of sinusitis/rhinitis should be informed of the increased risk.
Topics: Chronic Disease; Cross-Sectional Studies; Humans; Maxillary Sinusitis; Prevalence; Retrospective Studies; Rhinitis; Risk Factors; Sinusitis; Skull Fractures
PubMed: 35275862
DOI: 10.1097/SCS.0000000000008632 -
Chirurgia (Bucharest, Romania : 1990) Feb 2024Odontogenic 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...
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. 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. 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). 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.
Topics: Humans; Maxillary Sinusitis; Neoplasm Recurrence, Local; Retrospective Studies; Sinus Floor Augmentation; Sinusitis; Treatment Outcome; Adult
PubMed: 38465718
DOI: 10.21614/chirurgia.2024.v.119.i.1.p.76 -
Vestnik Otorinolaringologii 2020The state of the nasal cavity, especially the region of the osteomyomatic complex, plays a significant role in the development of chronic maxillary sinusitis....
The state of the nasal cavity, especially the region of the osteomyomatic complex, plays a significant role in the development of chronic maxillary sinusitis. Odontogenic maxillary sinusitis, as a complication of dental implantological treatment on the upper jaw, is increasingly common. The aim of the study was to increase the effectiveness of prophylaxis and treatment of odontogenic purulent upper jaw sinusitis during reconstructive operations on the alveolar region of the upper jaw. 3 groups of patients were examined: before dental treatment, after dental treatment in the development of odontogenic maxillary sinusitis and 30 patients were selected and examined, who underwent reconstructive surgeries on the alveolar process of the upper jaw and in whom the postoperative period was without complications. The diagnoses of 1st and 2nd group patients required surgical treatment. FESS allows restoring the physiological aeration of maxillary sinuses as naturally as possible, which is important for correct reparative bone regeneration in the alveolar region of maxilla.
Topics: Humans; Maxilla; Maxillary Sinus; Maxillary Sinusitis; Postoperative Period; Plastic Surgery Procedures
PubMed: 32885635
DOI: 10.17116/otorino20208504140 -
Laryngoscope Investigative... Apr 2022Odontogenic maxillary sinusitis (OMS) is a well-recognized disease in otolaryngology and oral and maxillofacial surgery. It is diagnosed comprehensively based on the...
OBJECTIVE
Odontogenic 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.
METHODS
We 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.
RESULTS
Lund-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.
CONCLUSIONS
Collectively, 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.
PubMed: 35434313
DOI: 10.1002/lio2.765 -
Oral Radiology Jul 2023To clarify the performance of transfer learning with a small number of Waters' images at institution B in diagnosing maxillary sinusitis, based on a source model trained...
OBJECTIVES
To clarify the performance of transfer learning with a small number of Waters' images at institution B in diagnosing maxillary sinusitis, based on a source model trained with a large number of panoramic radiographs at institution A.
METHODS
The source model was created by a 200-epoch training process with 800 training and 60 validation datasets of panoramic radiographs at institution A using VGG-16. One hundred and eighty Waters' and 180 panoramic image patches with or without maxillary sinusitis at institution B were enrolled in this study, and were arbitrarily assigned to 120 training, 20 validation, and 40 test datasets, respectively. Transfer learning of 200 epochs was performed using the training and validation datasets of Waters' images based on the source model, and the target model was obtained. The test Waters' images were applied to the source and target models, and the performance of each model was evaluated. Transfer learning with panoramic radiographs and evaluation by two radiologists were undertaken and compared. The evaluation was based on the area of receiver-operating characteristic curves (AUC).
RESULTS
When using Waters' images as the test dataset, the AUCs of the source model, target model, and radiologists were 0.780, 0.830, and 0.806, respectively. There were no significant differences between these models and the radiologists, whereas the target model performed better than the source model. For panoramic radiographs, AUCs were 0.863, 0.863, and 0.808, respectively, with no significant differences.
CONCLUSIONS
This study performed transfer learning using a small number of Waters' images, based on a source model created solely from panoramic radiographs, resulting in a performance improvement to 0.830 in diagnosing maxillary sinusitis, which was equivalent to that of radiologists. Transfer learning is considered a useful method to improve diagnostic performance.
Topics: Humans; Maxillary Sinusitis; Radiography, Panoramic; Radiography; Deep Learning; Radiologists
PubMed: 36166134
DOI: 10.1007/s11282-022-00658-3 -
American Journal of Rhinology & Allergy Jun 2024Subtypes of sinusitis have different symptoms and prognoses due to different pathogens. Odontogenic maxillary sinusitis (OMS) mainly occurs unilaterally and is different...
BACKGROUND
Subtypes of sinusitis have different symptoms and prognoses due to different pathogens. Odontogenic maxillary sinusitis (OMS) mainly occurs unilaterally and is different from chronic rhinosinusitis (CRS) usually occurring bilaterally in terms of clinical characteristics. However, comprehensive microbiological comparisons between OMS and CRS have never been systematically conducted and most comparisons are methodologically biased. This study aims to provide a comprehensive analysis of the microbiology associated with OMS and CRS through a meta-analysis approach in order to provide evidence for differential diagnosis of OMS and CRS from a microbiological perspective.
METHODS
The databases PubMed and CNKI were searched from their inception to July 2023. A random-effects model was employed to derive the pooled prevalence estimates of the identified bacterial species or genera.
RESULTS
The 17 represented studies included 6 concerning OMS, 12 concerning CRS, and 4 concerning normal sinus, yielding 191, 610, and 92 samples, respectively. Though not statistically significant, the prevalence of and was generally higher in OMS compared to CRS. Notably, was identified as the only genus with a significantly higher prevalence in OMS compared to CRS.
CONCLUSION
was significantly more prevalent in OMS compared with CRS, while was more prevalent in CRS than in OMS. Such differences in bacterial profile may partly explain the distinct pathology observed and contribute to the development of novel strategies for diagnosis and therapeutic interventions in OMS.
PubMed: 38881270
DOI: 10.1177/19458924241259333 -
The Cochrane Database of Systematic... Oct 2015Currently, two separate Cochrane reviews, ‘’ and ‘’ describe the effect of antibiotics for acute rhinosinusitis. Although both Cochrane reviews study the same... (Meta-Analysis)
Meta-Analysis Review
Currently, two separate Cochrane reviews, ‘’ and ‘’ describe the effect of antibiotics for acute rhinosinusitis. Although both Cochrane reviews study the same condition, they look at different populations (patients in which the diagnosis was based on clinical signs and symptoms and patients in which the diagnosis was confirmed by imaging). Because of this, the conclusions are different in these Cochrane reviews. This was confusing for clinicians who needed to read both Cochrane reviews to know which conclusions are most applicable to their patients. This review is being withdrawn and will be incorporated into the updated publication of ‘’. This ‘merged’ review will still maintain the relevant distinction between the two populations. However, information on the effectiveness of antibiotics for rhinosinusitis will be published in the ‘merged’ Cochrane review. We will omit the comparison between antibiotics (as published in this Cochrane review) because the choice for certain antibiotics and/or doses differs according to the local antibiotic resistance patterns and therefore this comparison is less relevant. The editorial group responsible for this previously published document have withdrawn it from publication.
Topics: Acute Disease; Adult; Anti-Bacterial Agents; Clinical Trials as Topic; Humans; Maxillary Sinusitis; Randomized Controlled Trials as Topic
PubMed: 26471061
DOI: 10.1002/14651858.CD000243.pub4