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International Journal of Paleopathology Jun 2024To assess the differences between endoscopic and radiological methods of analysis for diagnosing chronic maxillary sinusitis (CMS) in archaeological skeletal remains. (Comparative Study)
Comparative Study
OBJECTIVE
To assess the differences between endoscopic and radiological methods of analysis for diagnosing chronic maxillary sinusitis (CMS) in archaeological skeletal remains.
MATERIALS
32 crania from a Dutch post-medieval rural population.
METHODS
We assessed the presence of bone changes indicative of CMS (i.e., bone growth and bone resorption) both endoscopically and through computed tomography (CT), and then compared results.
RESULTS
We observed moderate agreement between bone growth scores obtained through endoscopy and CT, and fair agreement when assessing bone resorption.
CONCLUSIONS
CMS prevalence rates observed through CT may be comparable to rates assessed endoscopically, although caution is needed when making direct comparisons.
SIGNIFICANCE
This is the first study comparing data obtained through endoscopy and radiological methods in the study of CMS, informing paleopathologists about potential biases in data comparison.
LIMITATIONS
Our small sample size likely impacted results.
SUGGESTIONS FOR FURTHER RESEARCH
Further research is advised to fully explore the comparability of endoscopic and radiological method of analysis in the study of sinusitis.
DATA AVAILABILITY
The datasets generated and analyzed during the current study are available upon request.
Topics: Humans; Maxillary Sinusitis; Tomography, X-Ray Computed; Chronic Disease; Male; Endoscopy; Female; Netherlands; Adult; Paleopathology; Middle Aged
PubMed: 38643685
DOI: 10.1016/j.ijpp.2024.04.001 -
American Journal of Otolaryngology 2022Although the symptoms and radiographic signs may mimic rhinogenic sinusitis, odontogenic sinusitis (OS) with periapical lesions (PALs) is fundamentally an endodontic... (Observational Study)
Observational Study
INTRODUCTION
Although the symptoms and radiographic signs may mimic rhinogenic sinusitis, odontogenic sinusitis (OS) with periapical lesions (PALs) is fundamentally an endodontic infection. It is considered to be one of the main causes of OS, especially when presented unilaterally. Despite this routine dental examination is not performed and periapical infection frequently remains undiagnosed by otolaryngologists and radiologists.
MATERIAL AND METHODS
This prospective observational study covered a group of 61 patients with symptomatic OS with PAL. Assessment of quality of life was done using the 22-item Sino-Nasal Outcome Test-22 (SNOT-22) and Oral Health-Impact Profile-14 (OHIP-14). Temporal and etiological relationship between the dental cause and sinonasal complication was established among the otolaryngologist and dental specialist based on the clinical symptoms, nasal endoscopy described according to the modified Lund-MacKay scale, computed tomography (CT) scans measured and scored in compliance with Lund- Kennedy, Zinreich and Estrela scales.
RESULTS
Out of 61 patients, 28 (46%) were women and 33 (54%) men. Group median age 49.1 years, ranged from 22.8 to 78.9 years. Total OHIP-14 score was 12.7 ± 11.3, with the highest value obtained in domains describing physical pain (mean 2.9 ± 2.4, median 3) in which the highest score was obtained in item 3 - painful aching in mouth and/or teeth - scored ≥2 by 52.5% of participants. Concerning dental symptoms 11.5% of patients were asymptomatic. Total SNOT-22 score was 40.7 ± 21.1, with the highest value in domains describing nasal symptoms. 23% of patients reported mild, 44.3% moderate and 32.7% severe symptoms. In the endoscopic evaluation 86.8% of cases presented discharge, 73.8% mucosal edema. In 11.5% of cases the polypoid tissues was observed in nasal cavities. The first molar tooth was the most frequently affected with an incidence of 42.6%, followed by the second molar (27.9%). In 33 (48.5%) of cases the inflammatory process caused the discontinuity of the sinus floor, which in 51.5% coexisted with total maxillary sinus opacification. 10 teeth (14.7%) had the periapical lesions with a diameter exceeding 8 mm. In case of the multi-rooted teeth, PALs were usually encountered at more than one root (57.4%). Maxillary and ethmoid sinus were affected in 54% of cases and additional frontal sinus involvement in 32.8%. In 69.6% patients, ostiomeatal complex was obstructed.
CONCLUSIONS
Persistent sinonasal symptoms such as rhinorrhea, post-nasal drip and nose congestion along with dental pain may suggest endodontic nature of OS, especially after previous root-canal treatment. The bigger the PAL is in diameter and the closer to the maxillary sinus, the greater effect on its mucosal involvement and obstruction of ostiomeatal complex is observed. PALs around molar or premolar tooth apexes with coexistence of unilateral sinus opacifications should be noticed and mentioned by radiologists and evaluated by dental specialists in order to refer the patient to further treatment.
Topics: Adult; Aged; Chronic Disease; Endoscopy; Female; Humans; Male; Maxillary Sinus; Maxillary Sinusitis; Middle Aged; Quality of Life; Rhinitis; Sinus Floor Augmentation; Sinusitis; Young Adult
PubMed: 34968816
DOI: 10.1016/j.amjoto.2021.103338 -
Journal of the Chinese Medical... Oct 2018The aim of this study was to evaluate the diagnostic efficacy of sinus ultrasound for acute and subacute maxillary sinusitis (ASMS) by investigating the agreement...
BACKGROUND
The aim of this study was to evaluate the diagnostic efficacy of sinus ultrasound for acute and subacute maxillary sinusitis (ASMS) by investigating the agreement between different tools. We also proposed a confirmatory tool directed protocol for adult acute sinusitis, to enhance diagnostic accuracy.
METHODS
This prospective cohort study enrolled patients who were older than 18 years, with a diagnosis of maxillary sinusitis. The duration of symptoms was confined to less than 12 weeks. Rigid nasal endoscopy, sinus ultrasound, and plain sinus film were performed for all patients on the same day to confirm the diagnosis. Kappa statistics were used to test interrater reliability.
RESULTS
A total of 148 maxillary sinuses in 74 patients (38 men, 36 women) were evaluated. Sinus ultrasound and rigid nasal endoscopy disclosed the best agreement (agreement = 0.78, κ = 0.556). The agreement of rigid nasal endoscopy and plain sinus film was relatively poor (agreement = 0.72, κ = 0.446). Sinus ultrasound and plain sinus film had the poorest diagnostic consistency (agreement = 0.67, κ = 0.338).
CONCLUSION
Sinus ultrasound is a quick, safe, cost effective, and relatively easy-to-use technique for clinicians to evaluate the maxillary sinus. Sinus ultrasound and rigid nasal endoscopy are complementary tests to confirm the diagnosis of ASMS.
Topics: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Female; Humans; Male; Maxillary Sinus; Maxillary Sinusitis; Middle Aged; Prospective Studies; Tomography, X-Ray Computed; Ultrasonography; Young Adult
PubMed: 29779998
DOI: 10.1016/j.jcma.2018.03.005 -
Laryngo- Rhino- Otologie Jul 2021In recent years, an increasing number of dental infections of the maxillary sinus has been observed. A prerequisite for a bacterial infection of the maxillary sinus is...
In recent years, an increasing number of dental infections of the maxillary sinus has been observed. A prerequisite for a bacterial infection of the maxillary sinus is the perforation of Schneider's membrane. Pathogenetically, the ostiomeatal unit is only secondarily involved due to the infection ascending from the maxillary sinus floor. Besides the anamnesis, imaging procedures are important, whereby the high-resolution CT and CBCT (cone beam CT) have a special task due to their three-dimensional resolution. A dental X-ray or a dental examination for diagnosis is not sufficient in many cases. Due to the anatomy, the molars in particular are to be regarded as the cause of dentogenic sinusitis. The germ spectrum is polymicrobial with a dominance of anaerobes. Therapeutically, we favour one-stage surgery with rehabilitation of the underlying process and functional sinus surgery. Functional sinus surgery can also make a significant contribution to the rehabilitation of inflammatory complications in implantology.
Topics: Cone-Beam Computed Tomography; Humans; Maxillary Sinus; Maxillary Sinusitis; Sinus Floor Augmentation; Sinusitis
PubMed: 33472243
DOI: 10.1055/a-1339-1606 -
The British Journal of Oral &... Jun 2019Our aim was to investigate the prevalence of Haller cells in a group of patients listed for sinus lifting, and to assess the correlation between postoperative maxillary...
Our aim was to investigate the prevalence of Haller cells in a group of patients listed for sinus lifting, and to assess the correlation between postoperative maxillary sinusitis and their presence. A total of 102 patients (150 sides) were evaluated retrospectively on cone-beam computed tomography (CT). The presence and dimensions of Haller cells were noted on the scans. The development of postoperative maxillary sinusitis was recorded. Fisher's exact test was used for statistical evaluation and probabilities of less than 0.05 were considered significant. Maxillary sinusitis developed after sinus lifting in five patients, and Haller cells were found in three of them. However, there was no correlation between the presence of Haller cells and postoperative maxillary sinusitis (p=0.638). The cells were larger in patients with postoperative maxillary sinusitis, and the greater dimensions may be a potential risk factor for developing it after a sinus lift.
Topics: Cone-Beam Computed Tomography; Humans; Maxillary Sinus; Maxillary Sinusitis; Minimally Invasive Surgical Procedures; Paranasal Sinuses; Postoperative Complications; Postoperative Period; Retrospective Studies; Sinus Floor Augmentation; Turkey
PubMed: 31085018
DOI: 10.1016/j.bjoms.2019.04.013 -
Stomatologiia 2021The aim of the study was to study the structure of odontogenic sinusitis and identify iatrogenic etiological factors.
OBJECTIVE
The aim of the study was to study the structure of odontogenic sinusitis and identify iatrogenic etiological factors.
MATERIAL AND METHODS
A retrospective analysis of the case histories of patients operated from 2015 to 2019 with a diagnosis of «Sinusitis» in the Clinical City Emergency Hospital in Tashkent, Republic of Uzbekistan in the department of emergency maxillofacial surgery was carried out. The total number of patients was 333 people: 105 (31.5%) men and 228 (68.5%), the average age of patients was 39.4 years.
RESULTS
When analyzing the reasons for the development of sinusitis, in 73% of the total number of operated patients, there was an associated lesion of the teeth. When detailing the sources of odontogenic infection, it was determined that periapical foci of inflammation (granulomatous, granulating periodontitis, cystogranulomas) accounted for 26%, foreign bodies (teeth, roots of teeth, filling materials removed into the maxillary sinus during endodontic treatment) 31%, fistulous passages after removal teeth and attempts to eliminate perforation by surgery 43%. Other etiological factors were found: chronic polypous rhinosinusitis 14%, benign tumors 8%, allergic fungal sinusitis 5%.
CONCLUSION
Clinical analysis showed that the development of most cases of odontogenic sinusitis is associated with the mistakes of dentists and is of iatrogenic origin. To prevent the development of odontogenic iatrogenic sinusitis, prior to dental interventions on the teeth of the upper jaw, it is necessary to carry out a topical diagnosis of their ratio with the maxillary sinus.
Topics: Adult; Humans; Iatrogenic Disease; Male; Maxillary Sinus; Maxillary Sinusitis; Retrospective Studies; Sinusitis
PubMed: 34357740
DOI: 10.17116/stomat2021100041123 -
American Journal of Rhinology & Allergy Nov 2022Orbital, intracranial, and osseous extra-sinus complications can arise from bacterial or fungal sinusitis. Odontogenic sinusitis (ODS) can cause extra-sinus...
BACKGROUND
Orbital, intracranial, and osseous extra-sinus complications can arise from bacterial or fungal sinusitis. Odontogenic sinusitis (ODS) can cause extra-sinus complications, but its prevalence remains poorly characterized.
OBJECTIVE
To determine the frequency of ODS as a cause of operative extra-sinus infectious complications and describe clinical features of all complicated sinusitis cases.
METHODS
A multi-institutional retrospective review was performed on all operative sinusitis-related extra-sinus complications from 2011 to 2020. ODS was diagnosed by sinus computed tomography (CT) and dental evaluations when available. Demographics, complication types, sinusitis etiologies, and various clinical features were analyzed.
RESULTS
Forty-five patients were included (mean age 55.5 years, 56% male). Of the extra-sinus complications, 40% were orbital only, 22% intracranial only, 13% osseous only, and 25% involved combined complications. The 2 most common causes of extra-sinus complications were ODS (40%) and mucopyocele (27%). When invasive fungal etiologies were excluded, and only unilateral maxillary opacification on CT was considered, nearly 60% of extra-sinus complications were due to ODS. Unilateral maxillary sinus opacification on CT was present in 100% of complicated ODS compared to 44% of nonodontogenic cases, and oral anaerobes were only identified in ODS cases. No complicated ODS patients underwent dental interventions during hospitalization.
CONCLUSION
ODS was the most common cause of operative extra-sinus infectious complications. Clinicians should consider ODS high on the differential diagnosis of all patients presenting with complicated sinusitis, especially when sinusitis is unilateral and invasive fungal infection is not suspected.
Topics: Female; Humans; Male; Maxillary Sinus; Maxillary Sinusitis; Middle Aged; Retrospective Studies; Sinusitis; Tomography, X-Ray Computed
PubMed: 35876310
DOI: 10.1177/19458924221114941 -
European Archives of... Dec 2023Understanding the anatomy of the paranasal sinuses and their variations is essential to achieving safe and effective endoscopic sinus surgery. The ethmomaxillary sinus...
PURPOSE
Understanding the anatomy of the paranasal sinuses and their variations is essential to achieving safe and effective endoscopic sinus surgery. The ethmomaxillary sinus (EMS) is a relatively under-researched anatomical variation. This study investigated the prevalence, clinical features, and effect of EMS on the maxillary sinus in comparison with Haller's cells.
METHODS
Patients who visited the Rhinology Clinic at our hospital for rhinologic symptoms between January 2020 and December 2020. Computed tomography (CT) scans of paranasal sinuses were obtained at 1 mm-section thickness. Using CT scans, we investigated the clinical features of EMS, measured maxillary sinus volume, and analyzed the presence of maxillary sinusitis.
RESULTS
EMS was observed in 26 of the 250 patients (10.4%). The male-to-female ratio was equal. The age ranged from 18 to 83 years (mean age, 56.3). Of the patients with EMS, 65.4% were unilateral and 34.6% were bilateral. The prevalence of Haller's cells was similar to that in EMS (10.8%). In the analysis of patients with unilateral EMS, the EMS side was found to have a significantly reduced maxillary sinus volume compared to the opposite side, whereas the difference was not significant in Haller's cells. There was no significant relationship between EMS or Haller's cells and maxillary sinusitis.
CONCLUSIONS
EMS can significantly affect maxillary sinus volume. Therefore, surgeons should thoroughly review PNS CT scans before paranasal sinus surgery to determine the presence and features of EMS.
Topics: Humans; Male; Female; Adolescent; Young Adult; Adult; Middle Aged; Aged; Aged, 80 and over; Maxillary Sinusitis; Ethmoid Sinus; Maxillary Sinus; Tomography, X-Ray Computed; Endoscopy
PubMed: 37552283
DOI: 10.1007/s00405-023-08148-w -
Odontology Oct 2021To investigate the use of transfer learning when applying a deep learning source model from one institution (institution A) to another institution (institution B) for...
To investigate the use of transfer learning when applying a deep learning source model from one institution (institution A) to another institution (institution B) for creating effective models (target models) for the detection of maxillary sinuses and diagnosis of maxillary sinusitis on panoramic radiographs. In addition, to determine appropriate numbers of training data for the transfer learning. Source model was created using 350 panoramic radiographs from institution A as training data. Transfer learning was performed by adding 25, 50, 100, 150, or 225 panoramic radiographs as training data from institution B to the source model; this yielded the target models T25, T50, T100, T150 and T225. Each model was then evaluated using test data that comprised 40 images from institution A, 30 images from institution B. The performance indices (recall, precision and F1 score) for detecting the maxillary sinuses by the source model exceeded 0.98 when using test data A from institution A, but they deteriorated when using test data B from institution B. In the evaluation of target models using test data B, model T25 showed improved detection performance (recall of 0.967). The diagnostic performance of model T50 for maxillary sinusitis exceeded 0.9 in sensitivity. Transfer learning, which involves applying a small amount of data to the source model, yielded high performances in detecting the maxillary sinuses and diagnosing the maxillary sinusitis on panoramic radiographs. This study serves as a reference when adapting source models to other institutions.
Topics: Humans; Machine Learning; Maxillary Sinus; Maxillary Sinusitis; Radiography, Panoramic
PubMed: 34023953
DOI: 10.1007/s10266-021-00615-2 -
The Annals of Otology, Rhinology, and... Aug 2023Performing an effective maxillary antrostomy is critical to improving chronic maxillary sinusitis symptomatology. Incomplete dissection of the uncinate process and...
BACKGROUND AND OBJECTIVES
Performing an effective maxillary antrostomy is critical to improving chronic maxillary sinusitis symptomatology. Incomplete dissection of the uncinate process and failure to incorporate the natural drainage pathway may lead to recirculation and need for revision surgery. The purpose of this study is to determine if 70° endoscopes provide added value in determining incomplete dissection or residual disease.
METHODS
Prospective study of 35 sinuses from 18 patients undergoing FESS for Chronic Rhinosinusitis (CRS) between 11/1/2020 and 4/30/2021. Two fellowship trained Rhinologists initially performed maxillary antrostomies exclusively using a 0° endoscope, then transitioned to a 70° endoscope. Surgeons completed a survey to assess completion of the antrostomy prior to use of 70° endoscope, sino-nasal anatomy, and difficulty of the operation. Intraoperative photographs before and after using a 70° endoscope were evaluated by a third party. Pre-operative CT scans were used to evaluate the sphenoid keel-caudal septum-nasolacrimal duct (SK-CS-NL) angle.
RESULTS
Of 35 sinuses from 18 patients all 35 sinuses had CRS with 48.5% having nasal polyposis and 42.9% having active infection. There was residual inflammatory tissue in the anterior maxillary sinus, including polypoid tissue and uncinate process prior to using the 70° endoscope in 82.9% of sinuses. The natural drainage pathway was not incorporated into the dissection in 28.6% of sinuses before converting to 70° endoscope. Incomplete dissection with 0° endoscope was not associated with nasal polyposis ( = .086) or uncinate position (0.741). Narrow SK-CS-NL angles were associated with incomplete dissection of the anterior maxillary sinus with 0° endoscope (16.0° ± 3.0° vs 20.6° ± 3.2°; = .013).
CONCLUSION
Use of 70° endoscope in maxillary antrostomy may be beneficial in identifying and resecting disease within the anterior maxillary sinus that may otherwise be difficult to find using a 0° endoscope. This is especially true in patients with narrow nasolacrimal duct positioning.
Topics: Humans; Endoscopy; Prospective Studies; Sinusitis; Maxillary Sinus; Maxillary Sinusitis; Nasal Polyps; Chronic Disease
PubMed: 35983610
DOI: 10.1177/00034894221119306