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Ear, Nose, & Throat Journal Mar 2022Bisphosphonates are used for the treatment of bone metastases of cancer and prevention of osteoporosis. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) has...
Bisphosphonates are used for the treatment of bone metastases of cancer and prevention of osteoporosis. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) has unclear mechanisms, but its elucidation, prevention, and treatment are essential to improve patient outcomes.An 88-year-old woman who was taking oral bisphosphonates for 4 years presented with a 5-day history of gradual orbital pain. Computed tomography (CT) revealed bilateral maxillary sinusitis and bony destruction at the base of the right maxillary sinus and inferior orbital wall. We diagnosed her with bisphosphonate-related osteonecrosis of the maxilla. In addition to intravenous antibiotic treatment, an endoscopic sinus surgery was performed. The patient's postoperative course was uneventful.To the best of our knowledge, this is the first case report of BRONJ with orbital cellulitis. This condition should be considered among patients taking bisphosphonates, who manifest with symptoms of orbital cellulitis and bone destruction on imaging.
PubMed: 35357247
DOI: 10.1177/01455613221086028 -
Diagnostics (Basel, Switzerland) Dec 2022During oral rehabilitation, dental implants in the posterior maxilla can penetrate the maxillary sinus. The aim was to evaluate the presence of maxillary sinus...
BACKGROUND
During oral rehabilitation, dental implants in the posterior maxilla can penetrate the maxillary sinus. The aim was to evaluate the presence of maxillary sinus abnormalities in patients with dental implants in the posterior maxillary region using cone-beam computed tomography (CBCT) images.
MATERIALS AND METHODS
This was a retrospective cross-sectional study, and CBCT scans of 199 patients (459 dental implants) were evaluated. Implants were assessed according to their relative location to the maxillary sinus floor (up to 2 mm from the maxillary sinus cortex, within 2 mm to intimate contact with the maxillary sinus cortex, apical third inside the maxillary sinus, two-thirds or more inside the maxillary sinus) and bone-fixation tissue (Alveolar ridge or Bone graft). Maxillary sinus abnormalities were classified. Kappa and Weighted Kappa and the Kruskal-Wallis test were applied.
RESULTS
A higher prevalence of mucosal thickening and non-specific opacification were observed in implants located within 2 mm to intimate contact with the cortex of the maxillary sinus floor. Of the 66 implants with apical thirds located inside the maxillary sinus, 31 (46.7%) were associated with sinus abnormalities and of all implants ( = 5) with two-thirds or more located inside the maxillary sinus, all of these were associated with sinus abnormalities. No association was observed in relation to implant bone-fixation tissue.
CONCLUSIONS
This study found a significant association between dental implant placement near or within the sinus and sinus abnormalities, mainly mucosal thickening and non-specific opacification.
PubMed: 36553176
DOI: 10.3390/diagnostics12123169 -
Ear, Nose, & Throat Journal Aug 2022This study aimed to investigate and analyze the anatomic characteristics of the retromaxillary cell (RMC) by using computed tomography (CT) images of paranasal sinuses...
OBJECTIVE
This study aimed to investigate and analyze the anatomic characteristics of the retromaxillary cell (RMC) by using computed tomography (CT) images of paranasal sinuses and to improve its identification with ethmomaxillary sinus (EMS).
METHODS
The paranasal sinus CT scans of 441 outpatients or inpatients in our hospital from January 2018 to October 2018 were analyzed. The incidence of RMC, EMS, Haller cell, imaging anatomical characteristics, and morphological manifestations were observed via sinus CTs. The relationship of RMC and ipsilateral maxillary sinusitis was analyzed.
RESULTS
The incidence of RMC is 83.90% (740/882). The incidence of males and females was 83.81% (414/494) and 84.02% (326/388), respectively. The incidence of bilateral (72.79%, 321/441) was much higher than that of unilateral (22.22%, 98/441). The lateral extension of the RMC ranged from 1.18 to 13.31 mm, with an average of 6.10 ± 2.03 mm. The incidence of ipsilateral maxillary sinus opacification on the RMC sides and non-RMC sides has no significance difference (χ = .054, = .459). The incidence of Haller cell and EMS decreased significantly in the presence of RMC ( < .01).
CONCLUSION
The RMC is an anatomical variation originating from posterior ethmoid cells, which is commonly encountered in the clinic. The pneumatization of RMC is highly variable, and a bilateral is common. During endoscopic sinus surgery, it is necessary to carefully identify such an air cell to ensure the complete opening of the paranasal sinus during surgery.
Topics: Ethmoid Bone; Female; Head; Humans; Male; Maxillary Sinus; Maxillary Sinusitis; Paranasal Sinuses; Tomography, X-Ray Computed
PubMed: 32627620
DOI: 10.1177/0145561320936963 -
Case Reports in Otolaryngology 2016Osteomyelitis of the maxilla is now a rare event with the advent of antibiotics. The two predominant causes are odontogenic infections and sinusitis. Immunocompromised...
Osteomyelitis of the maxilla is now a rare event with the advent of antibiotics. The two predominant causes are odontogenic infections and sinusitis. Immunocompromised states such as diabetes, HIV, and malnutrition increase the risk of osteomyelitis. It is important to recognize this early as it is a difficult entity to treat with potentially serious consequences. We report an unusual case of right sided maxillary osteomyelitis in a lady with poorly controlled diabetes in rural Lincolnshire. Biopsy of the right maxillary bone showed features of acute osteomyelitis. This responded well to a prolonged course of oral antibiotics.
PubMed: 27648332
DOI: 10.1155/2016/9723806 -
Case Reports in Dentistry 2022Endoscopic sinus surgery is commonly performed to treat odontogenic maxillary sinusitis. However, recurrence and natural ostium reclosure often occur due to the...
Endoscopic sinus surgery is commonly performed to treat odontogenic maxillary sinusitis. However, recurrence and natural ostium reclosure often occur due to the inadequate patency of the excretory route. Furthermore, classical maxillary sinus radical surgery is still performed for odontogenic maxillary sinusitis even though it can cause postoperative maxillary sinus deformation, loss of function, and a postoperative maxillary cyst. A management that addresses these issues has not yet been identified. This study reported a conservative maxillary sinus management, wherein a nasoantral window is prepared and the thickened maxillary sinus mucosa is preserved, using the Caldwell-Luc approach. This study presents a case of severe odontogenic maxillary sinusitis that spread to the frontal sinus. This novel management facilitated complete recovery from severe odontogenic maxillary sinusitis in this case.
PubMed: 35935340
DOI: 10.1155/2022/1614739 -
International Journal of Environmental... Jun 2022Although maxillary sinusitis often occurs in patients with medication-related osteonecrosis of the jaw (MRONJ) of the upper jaw, there have been few reports on the...
Although maxillary sinusitis often occurs in patients with medication-related osteonecrosis of the jaw (MRONJ) of the upper jaw, there have been few reports on the treatment and outcomes for maxillary sinusitis associated with maxillary MRONJ. This study aimed to retrospectively investigate the treatment outcomes of maxillary sinusitis in patients with MRONJ of the upper jaw. There were 34 patients diagnosed with maxillary MRONJ and sinusitis by preoperative computed tomography who underwent surgery in our institution between January 2011 and December 2019. Age, sex, primary disease, stage of MRONJ, class and administration period of an antiresorptive agent, corticosteroid administration, preoperative leukocyte count and serum albumin level, periosteal reaction, sinusitis grade, maxillary sinus surgical procedure, and treatment outcomes of MRONJ and sinusitis were examined. There were 7 male and 27 female patients (average age, 74.7 years). Complete healing of MRONJ was obtained in 29 of 34 patients (85.3%). Maxillary sinusitis resolved or improved in 21 patients (61.8%) but did not change or worsen in 13 patients (38.2%). We found that complete resection of necrotic bone with intraoperative irrigation of the maxillary sinus may provide good treatment outcomes for maxillary sinusitis associated with MRONJ, although our findings were not statistically significant owing to the small number of patients.
Topics: Aged; Bisphosphonate-Associated Osteonecrosis of the Jaw; Bone Density Conservation Agents; Female; Humans; Male; Maxillary Sinusitis; Retrospective Studies; Treatment Outcome
PubMed: 35742679
DOI: 10.3390/ijerph19127430 -
Acta Odontologica Latinoamericana : AOL Apr 2024Differentiating orofacial odontogenic pain/disorders from pain/disorders associated with maxillary sinusitis is important to avoid unnecessary dentalprocedures and to...
UNLABELLED
Differentiating orofacial odontogenic pain/disorders from pain/disorders associated with maxillary sinusitis is important to avoid unnecessary dentalprocedures and to properly refer patients to colleagues/dentists and vice versa.
AIM
To analyze the association between apical lesions and sinus changes and to evaluate the agreement between the diagnoses of an endodontist, a radiologist, an oral and maxillofacial surgeon, and an otolaryngologist.
MATERIALS AND METHOD
385 axial, coronal, and sagittal MSCT scans were selected using an image archiving andcommunication system (PACS). The examinations had been performed between 2018 and 2022.
RESULTS
Apical lesions were observed in 36.10% of sinusitis cases, 73.8% of unilateralsinusitis cases, 48.7% of sinus floor discontinuity cases, and 67.2% of cases in which endodontic treatment had been performed. Agreement between the diagnoses made by the endodontist and those made by the other investigators was high for most study variables (k > 0.60). The exceptions were mucosal thickening, for which agreement between the endodontist and the other investigators was intermediate (k=0.397), and the presence of periapicallesions (k=0.010), previous endodontic treatment (k=0.013), and mucosal thickness (k=0.024), for which agreement between endodontists and radiologists was low. Conclusions: There was an association between sinus changes and apical lesions.
Topics: Humans; Female; Male; Middle Aged; Multidetector Computed Tomography; Adult; Periapical Diseases; Maxillary Sinusitis; Aged; Young Adult; Adolescent; Diagnosis, Differential
PubMed: 38920129
DOI: 10.54589/aol.37/1/79 -
Indian Journal of Otolaryngology and... Jun 2023In the present day scenario complications arising from sinusitis are rare, since the introduction of antibiotics. However Sinusitis and its complications are still...
In the present day scenario complications arising from sinusitis are rare, since the introduction of antibiotics. However Sinusitis and its complications are still existing and masking of symptoms due to inadequate dosage and duration of antibiotics, which is life threatening and if neglected may result in high morbidity and mortality. This case has been presented for its rare presentation of parafalcine abscess of left occipital lobe of middle cranial fossa, which is secondary to frontal sinusitis. A 40 year old male patient was admitted in ICU with chief complaints of fever for 3 days, headache and neck stiffness for 2 days and altered sensorium for 1 day. Computed tomography showed both frontals, ethmoids and maxillary sinusitis on the left side. Patient was given conservative treatment and showed partial improvement of symptoms. On repeat CT brain (after 2 weeks) showed abscess parasagittally in left occipital lobe. Neurosurgeon aspirated abscess through parasagittal approach. Later the patient referred to the ENT department and ESS (endoscopic sinus surgery) DRAF II procedure done for clearance of frontal sinus to avoid recurrence of intracranial complications.
PubMed: 37275101
DOI: 10.1007/s12070-022-03131-z -
Materials (Basel, Switzerland) Mar 2020To present a case series of zygomatic implants combined with bone regeneration and soft tissue enhancement techniques to reduce the risk of biological delayed...
PURPOSE
To present a case series of zygomatic implants combined with bone regeneration and soft tissue enhancement techniques to reduce the risk of biological delayed complications such as maxillary sinusitis and soft tissue recession.
MATERIALS AND METHODS
Zygomatic implants placed simultaneously with different bone regeneration techniques (buccal, palatal and buccal-palatal bone regeneration) and soft tissue enhancement techniques (pediculate and free connective tissue graft) were followed for at least 12 months. The following information was collected: patient age and sex, number of zygomatic implants, zygomatic implant success rate, zygomatic implant position according to classification of the Zygomatic Anatomy Guide Approach (ZAGA), sinus membrane perforation, type and outcome of the bone regeneration or the soft tissue enhancement technique, bone gain (width and length along the zygomatic implant) and keratinized buccal mucosa width, duration of follow-up, loading protocol (immediate or delayed) and biological complications (maxillary sinusitis and soft tissue recession).
RESULTS
Thirty-one zygomatic implants placed in 19 patients were included. All implants were successful and none of the implants presented biological complications. The bone regeneration technique was successful in 30 of 31 cases with a mean palatal bone width of 3 mm, buccal bone width of 2.65 mm, palatal bone length of 6.5 mm and buccal bone length of 8.3 mm. The success rate of soft tissue enhancement was 100% and it established at least 2 mm of keratinized buccal mucosa width in all implants.
CONCLUSIONS
Within the limitations of the present study, bone regeneration and soft tissue enhancement techniques were useful to establish more favorable conditions of the peri-implant tissues around zygomatic implants. This could prevent biological complications such as maxillary sinusitis and soft tissue recessions. Prospective and randomized controlled clinical trials with longer follow-up periods are advisable.
PubMed: 32235372
DOI: 10.3390/ma13071577 -
Ear, Nose, & Throat Journal May 2022Pott's puffy tumor (PPT) is a nonneoplastic complication of acute frontal sinusitis characterized by subperiosteal abscess (SPOA) formation and osteomyelitis. Although... (Review)
Review
Pott's puffy tumor (PPT) is a nonneoplastic complication of acute frontal sinusitis characterized by subperiosteal abscess (SPOA) formation and osteomyelitis. Although various clinical conditions are associated with frontal SPOA, cases associated with odontogenic sinusitis are rare. We report a recurrent case of frontal SPOA who had a previous history of craniotomy due to head trauma. The patient was presented with headache, facial swelling and diagnosed as frontal, ethmoid, and maxillary sinusitis with frontal SPOA, which is PPT. The patient was surgically managed by endoscopic sinus surgery and external drainage of the abscess. Although the symptoms had been relieved soon after the surgery, they were recurred after 1 week. By paranasal sinus computed tomography scans, it was suspected that severe carious teeth, which were missed before surgery, induced maxillary sinusitis which spread into the frontal sinus and subperiosteal areas inducing recurrence of disease. Our experience suggests that frontal SPOA may originate from odontogenic maxillary sinusitis caused by severe dental caries, which should be actively managed, especially in patients with the risk of spread of inflammation, such as those who have discontinuity in frontal bone.
Topics: Abscess; Dental Caries; Frontal Sinus; Frontal Sinusitis; Humans; Maxillary Sinusitis; Pott Puffy Tumor
PubMed: 32921154
DOI: 10.1177/0145561320952203