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Journal of Clinical Medicine Oct 2022Background: To assess the diagnostic utility of middle meatal culture (MMC) in patients with acute and chronic sinusitis; Methods: Six databases were thoroughly reviewed... (Review)
Review
Background: To assess the diagnostic utility of middle meatal culture (MMC) in patients with acute and chronic sinusitis; Methods: Six databases were thoroughly reviewed up to March 2022. Sensitivity, specificity, and negative and positive predictive values were extracted. Methodological quality was evaluated using the QUADAS-2 instrument; Results: Fifteen reports were analyzed. MMC results exhibited a significant correlation (r = 0.7590, 95% confidence interval [CI] [0.6855; 0.8172], p < 0.0001) with those of maxillary sinus puncture. The diagnostic odds ratio (DOR) of MMC (reference = maxillary sinus culture) was 8.5475 [3.9238; 18.6199]. The area under the summary receiver operating characteristic curve was 0.761. The sensitivity and specificity of MMC were 0.7759 [0.6744; 0.8526] and 0.7514 [0.6110; 0.8534], respectively. We performed subgroup analysis based on age (children vs. adults), duration of disease (acute vs. chronic), and specimen collection method (biopsy, swabs, suction tips). The DORs, specificities, and negative and positive predictive values varied significantly. Diagnostic accuracy was highest for children and individuals with chronic disease, and when samples were collected via suction.; Conclusions: MMC provided fair diagnostic accuracy in patients with acute or chronic sinusitis. Although some institutional differences were evident, the middle meatal and maxillary sinus culture results were similar.
PubMed: 36294389
DOI: 10.3390/jcm11206069 -
Journal of Clinical Medicine Jun 2021Odontogenic infections can directly trigger maxillary sinusitis. CBCT is an excellent choice for precise examination of maxillary sinuses and hard tissues within the...
Odontogenic infections can directly trigger maxillary sinusitis. CBCT is an excellent choice for precise examination of maxillary sinuses and hard tissues within the oral cavity. The objective of this retrospective and the cross-sectional study was to analyze the influence of odontogenic conditions on the presence and intensity of maxillary sinus mucous membrane thickening using CBCT imaging. Moreover, periodontal bone loss and anatomic relationship between adjacent teeth and maxillary sinuses were assessed to evaluate its possible impact on creating maxillary thickening. The study sample consisted of 200 maxillary sinuses of 100 patients visible on CBCT examination with a field of view of 13 × 15 cm. The presented study revealed a significant influence of periapical lesions, inappropriate endodontic treatment, severe caries, and extracted teeth on the presence of increased thickening of maxillary sinus mucous membrane. In addition, an increase in the distance between root apices and maxillary sinus floor triggered a significant reduction of maxillary sinus mucous membrane thickening. The presence of periodontal bone loss significantly increases maxillary sinus mucous membrane thickening.
PubMed: 34199113
DOI: 10.3390/jcm10132849 -
European Annals of Otorhinolaryngology,... Dec 2018Neurological complications of acute sinusitis are exceptional, but potentially serious.
INTRODUCTION
Neurological complications of acute sinusitis are exceptional, but potentially serious.
CASE REPORT
The authors report the case of a 6-year-old diabetic girl who presented with middle cerebral artery ischemic stroke secondary to inflammatory arteritis of the left internal carotid artery in a context of bilateral acute maxillary sinusitis. MRI confirmed ischaemic stroke associated with carotid arteritis and complete obstruction of the maxillary sinuses. A favourable outcome was observed after endoscopic drainage of the sinuses associated with broad-spectrum antibiotic therapy.
DISCUSSION
This complication was probably due to spread of an infectious inflammatory reaction of the intrapetrosal carotid artery and its branches via the pterygoid venous plexus. To our knowledge, this is the first published case report of maxillary sinusitis complicated by stroke.
Topics: Arteritis; Carotid Artery Diseases; Carotid Artery, Internal; Child; Female; Humans; Infarction, Middle Cerebral Artery; Magnetic Resonance Imaging; Maxillary Sinusitis
PubMed: 30072286
DOI: 10.1016/j.anorl.2018.07.004 -
International Archives of... Oct 2022The maxillary sinus and its variations are very important to dentistry and rhinology. To investigate the effect of the accessory maxillary ostium (AMO) on the...
The maxillary sinus and its variations are very important to dentistry and rhinology. To investigate the effect of the accessory maxillary ostium (AMO) on the variations of adjacent structures of the maxillary sinus. The computed tomography (CT) images of 400 patients were retrospectively evaluated. The prevalence of AMO was calculated. The relationship between morphological variations of adjacent structures of maxillary sinus such as agger nasi cell (ANC), Haller cell (HC), nasal septum deviation (NSD), hypertrophy of inferior concha (HIC), pneumatization of middle concha (PMC), mucus retention cyst (MRC), mucosal thickening (MT), and maxillary sinusitis (MS), as well as the presence of AMO, were investigated. Presence of AMO was diagnosed in 42 patients (10.5%), having been found in 4.5% of the patients only on the right side, in 1.25% of the patients only on the left side, and in 4.75% of the patients on both sides. There is an increasing incidence of ANC, HC, NSD, HIC, and PMC in the presence of AMO and MS. There is a decreasing incidence of MRC in the presence of AMO. Furthermore, AMO does not affect the incidence of MT. This study showed that most parameters, except for MRC and MT, had increasing incidence in the presence of AMO. It is important for radiologists and rhinologists to have knowledge about the location of AMO and the presence of variations of MS adjacent structures to avoid surgical complications.
PubMed: 36405481
DOI: 10.1055/s-0042-1742325 -
Dento Maxillo Facial Radiology Sep 2021We sought to determine whether an accessory maxillary ostium (AMO) is a congenital or acquired condition and we investigated concomitant sinus pathologies associated...
OBJECTIVE
We sought to determine whether an accessory maxillary ostium (AMO) is a congenital or acquired condition and we investigated concomitant sinus pathologies associated with this structure.
METHODS
Paranasal sinus CT examinations of individuals aged ≥13 years and <13 years were compared retrospectively. In total, 552 sinuses of 276 patients aged ≥13 years (Group 1) and 284 maxillary sinuses of 142 children aged <13 years (Group 2) were evaluated. Patients were classified as AMO-positive or -negative. The following features were evaluated in Group 1: AMO presence, mucus retention cysts, mucosal thickening, sinusitis of the maxillary sinus, nasal septum deviation, concha hypertrophy, concha bullosa, primary ostium obstruction, uncinate process atelectasis, paradox concha, Agger nasi and Haller cells, and sinus hypoplasia. The sizes and locations of AMOs were also evaluated. The presence of an AMO and sinusitis were evaluated in Group 2.
RESULTS
AMOs were detected in 122 sinuses in Group 1. In the AMO-positive group, sinusitis, mucosal thickening, and primary ostium obstruction were significantly more common than in the AMO-negative group (p < 0.00001). Statistically significant associations were not observed between AMO presence and other parameters. AMOs were present in two sinuses in Group 2.
CONCLUSION
Our results suggest that AMOs are acquired defects caused by sinus diseases. The rare occurrence of these structures in patients aged <13 years suggests that they may be a perforation or secondary drainage pathway in patients with sinusitis or primary ostium obstruction.
Topics: Humans; Maxilla; Maxillary Sinus; Nasal Septum; Retrospective Studies; Sinusitis
PubMed: 33591847
DOI: 10.1259/dmfr.20200575 -
Acta Otorrinolaringologica Espanola 2016Odontogenic sinusitis accounts for 10-12% of maxillary sinusitis. It occurs due to an interruption of the mucoperiosteum in response to a series of conditions, most... (Review)
Review
Odontogenic sinusitis accounts for 10-12% of maxillary sinusitis. It occurs due to an interruption of the mucoperiosteum in response to a series of conditions, most frequently the extraction of a superior tooth. Its treatment has two bases: treating the infection and managing the oroantral fistula that perpetuates the infection. Communications smaller than 5mm can resolve spontaneously; bigger ones must be closed by a flap. Bichat's fat pad flap was first used in 1977 to close an oroantral fistula. It is a pedicled flap that has been shown to be successful, with advantages that make it the best option in oroantral fistula treatment. Its location allows easy access, minimum dissection, great versatility, good mobility, good blood supply, low rate of complications, no morbidity in the donor site, low risk of infection, shortened surgical time and fast cover by epithelium, and it leaves no visible scar, amongst other benefits. That is why we encourage the use of this technique and choose it as the best option for management of our patients.
Topics: Adipose Tissue; Cheek; Humans; Oroantral Fistula; Sinusitis; Surgical Flaps
PubMed: 26481975
DOI: 10.1016/j.otorri.2015.03.001 -
Clinical Oral Investigations Mar 2021Chronic rhinosinusitis (CRS) frequently stems from a dental origin, although odontogenic sinusitis (OS) remains underdiagnosed amongst different professionals. This...
OBJECTIVES
Chronic rhinosinusitis (CRS) frequently stems from a dental origin, although odontogenic sinusitis (OS) remains underdiagnosed amongst different professionals. This study aimed to explore how often odontogenic causes are considered when diagnosing CRS.
MATERIALS AND METHODS
Patient records from 374 new CRS patients treated at a tertiary-level ear, nose, and throat (ENT) clinic were selected. Entries and radiological reports were assessed exploring how often dentition was mentioned and OS was suspected, how often radiologists reported maxillary teeth, and how commonly typical OS microbial findings and unilateral symptoms occurred.
RESULTS
Although 10.1% of the CRS diagnoses were connected to possible dental issues, teeth were not mentioned for 73.8% of patients. Radiological reports were available from 267 computed or cone beam computed tomographies, of which 25.1% did not mention the maxillary teeth. The reported maxillary teeth pathology was not considered in 31/64 (48.4%) cases. Unilateral symptoms associated with apical periodontitis (OR = 2.49, 95% CI 1.27-4.89, p = 0.008). Microbial samples were available from 88 patients, for whom Staphylococcus aureus was the most common finding (17% of samples).
CONCLUSIONS
Odontogenic causes are often overlooked when diagnosing CRS. To provide adequate treatment, routine assessment of patient's dental history and status, careful radiograph evaluation, and utilization of microbial findings should be performed. Close cooperation with dentists is mandatory.
CLINICAL RELEVANCE
Dental professionals should be aware of difficulties medical professionals encounter when diagnosing possible OS. Thus, sufficient knowledge of OS pathology is essential to both medical and dental professionals.
Topics: Cone-Beam Computed Tomography; Humans; Maxillary Sinusitis; Odontogenesis; Sinusitis; Tomography, X-Ray Computed
PubMed: 32500403
DOI: 10.1007/s00784-020-03384-4 -
Journal of Medicine and Life 2015There is a wide documentary material regarding the upper dental disease influencing the state of the maxillary sinus. This article tries to show that the relation is a...
There is a wide documentary material regarding the upper dental disease influencing the state of the maxillary sinus. This article tries to show that the relation is a two-way one.
Topics: Chronic Disease; Humans; Maxillary Sinus; Molar; Polyps; Radiography; Sinusitis
PubMed: 25914732
DOI: No ID Found -
Ear, Nose, & Throat Journal Dec 2022This case study demonstrates a 58-year-old female who contracted COVID-19 post-vaccination presenting with severe left-sided facial pain, headaches, and dyspnea. A...
This case study demonstrates a 58-year-old female who contracted COVID-19 post-vaccination presenting with severe left-sided facial pain, headaches, and dyspnea. A computed tomography was ordered and showed acute sinusitis, and upon bedside endoscopy, the patient was shown to have necrosis of the left-sided middle turbinate with no discoloration, palate necrosis, or facial changes. All samples of the necrotic tissue were reported to be invasive fungal sinusitis. The entire turbinate was resected in the operating room and ethmoid, frontal, and maxillary sinuses were healthy. Chest x-rays post-operatively showed pulmonary effusions and edema although the patient was not stable enough for a lung examination to rule out a pulmonary fungal infection. A bedside endoscopy showed no further necrosis post-operatively although a repeat endoscopy showed duskiness at the lateral attachment of the basal lamella right at the most posterior resection of the middle turbinate. The patient was placed on multiple antifungal agents. The patient remained in hypoxemic respiratory failure and septic shock while on pressors and 2 weeks following this, expired. Post-COVID-19 patients have been shown in the literature to have an increased risk of developing invasive fungal sinusitis (IFS) and all IFS cases during active COVID-19 infection have had a 100% mortality rate.
Topics: Humans; Female; Middle Aged; COVID-19; Sinusitis; Invasive Fungal Infections; Turbinates; Necrosis
PubMed: 35770808
DOI: 10.1177/01455613221112337 -
Nigerian Journal of Clinical Practice Apr 2022Surgical procedures in posterior area of maxillary might cause an oroantral communication and iatrogenic sinusitis. An undetected oroantral communication can cause the... (Review)
Review
Surgical procedures in posterior area of maxillary might cause an oroantral communication and iatrogenic sinusitis. An undetected oroantral communication can cause the penetration of foreign bodies, such as dental impression materials, in the maxillary sinus, thereby contributing to persistent sinusitis. Given the occurrence of a very rare clinical and medicolegal case of persistent and drug-resistant sinusitis due to radiologically undetected fragments of silicone paste for dental impression in the maxillary antrum, a literature review was pursued through sensitive keywords in relevant databases for health sciences. All retrieved articles were considered and data about the kind of impression materials thrusted into the maxillary sinus, the diagnostic issues, the reported range of symptoms, and the occurrence of medicolegal issues were analyzed. The diagnosis resulted to be quite challenging and belatedly especially in case of healed oroantral communication and when the material retained in the maxillary sinus has similar radiodensity compared to the surrounding normal or inflammatory tissues. The case was then discussed in comparison with the reviewed literature for both clinical and medicolegal issues. Hints were provided to professionals to face the challenging diagnosis in similar rare cases and to avoid the possible related litigation.
Topics: Foreign Bodies; Humans; Maxillary Sinus; Maxillary Sinusitis; Oroantral Fistula; Sinusitis
PubMed: 35439893
DOI: 10.4103/njcp.njcp_1662_21