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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 -
Journal of Endodontics Oct 2022The aim of this study was to determine the frequency and risk factors of maxillary sinusitis of endodontic origin (MSEO) on posterior maxillary teeth evaluated using...
INTRODUCTION
The aim of this study was to determine the frequency and risk factors of maxillary sinusitis of endodontic origin (MSEO) on posterior maxillary teeth evaluated using dynamic navigation and a novel filter of cone-beam computed tomographic (CBCT) imaging.
METHODS
CBCT scans of 453 patients (814 teeth) were selected. Data were divided into 4 groups: (1) root canal treatment (RCT), (2) relation of the root apex to the maxillary sinus, (3) apical periodontitis (AP), and (4) maxillary sinus inflammation (no inflammation, periapical osteoperiostitis, periapical mucositis, partial obstruction, or total obstruction). Frequency distribution and cross-tabulation were used for data analysis. The association of maxillary sinus abnormalities with other variables was analyzed using the chi-square test. The significance level was set at 5%, and the association between dependent and independent variables was analyzed using robust Poisson regression models.
RESULTS
MSEO was found in 65.6% of the cases, and the highest frequency rates were in the periapical mucositis (44%) and partial obstruction (15.8%) groups. The rates of risk factors were highest in the cases of RCT (54.9%), AP (34.3%), and the root apex in contact with the maxillary sinus (53.8%). The most frequent sex and age group were female (55.8%) and 41-50 years (30.5%).
CONCLUSIONS
The frequency of MSEO was high and positively associated with RCT, AP, and the root apex's position in contact with the floor of the maxillary sinus. The maxillary sinus filter of the CBCT software provides a clear image of maxillary sinus abnormalities.
Topics: Cone-Beam Computed Tomography; Female; Humans; Male; Maxillary Sinus; Maxillary Sinusitis; Mucositis; Periapical Periodontitis; Risk Factors
PubMed: 35948173
DOI: 10.1016/j.joen.2022.07.011 -
Diagnostics (Basel, Switzerland) Jun 2022The maxillary sinus is a structure at the border of specialties: otorhinolaryngology and maxillofacial surgery. Due to this fact, regarding etiology, it can be affected... (Review)
Review
The maxillary sinus is a structure at the border of specialties: otorhinolaryngology and maxillofacial surgery. Due to this fact, regarding etiology, it can be affected by both the rhinogenic and odontogenic path and can impose diagnostic difficulties. The etiopathogenic mechanisms that can affect the Schneiderian membrane are mainly inflammatory, iatrogenic, traumatic, and tumorous in nature. From a microbiological point of view, the bacteriology is polymorphic, including both aerobic and anaerobic species in acute OS, the predominating species in acute OS being aerobic, and in chronic anaerobic germs. The role of fungi in the determination of this pathology and in the production of the biofilm that leads to resistance to antibiotic treatment is also discussed. The present paper aims to present the etiopathogenesis, bacteriology, clinical manifestations, as well as treatment of odontogenic sinusitis (OS) from an updated perspective through reviewing the literature. If unilateral maxillary sinusitis is usually due to odontogenic causes, this does not clinically exclude the possibility of strictly rhinogenic causes in the occurrence of sinusitis. This underlines the important role of complex oral and rhinological clinical examination as well as the role of preclinical examinations in specifying the certainty diagnosis. Simple radiography, orthopantomography, CT, and CBCT are compared in terms of diagnostic accuracy. The treatment of OS is complex, involving medication, dental, and surgical measures. The value of endoscopic surgery is emphasized, comparing its advantages over the classic Caldwell-Luc technique.
PubMed: 35885504
DOI: 10.3390/diagnostics12071600 -
Current Opinion in Otolaryngology &... Feb 2023To review the various factors associated with the most common cause of maxillary sinus dysfunction; recalcitrant chronic maxillary sinusitis (RCMS). In addition,... (Review)
Review
PURPOSE OF REVIEW
To review the various factors associated with the most common cause of maxillary sinus dysfunction; recalcitrant chronic maxillary sinusitis (RCMS). In addition, available medical and surgical management options are discussed along with various tips and tricks for optimal management.
RECENT FINDINGS
Defects in mucociliary clearance, immunodeficiency, anatomic factors, and infectious etiologies have been implicated in dysfunction of the maxillary sinus leading to RCMS. Medical management including oral antibiotics or topical drugs have shown varying degrees of success. Endoscopic modified medial maxillectomy (EMMM) has been shown to significantly improve symptoms in patients with RCMS.
SUMMARY
A dysfunctional maxillary sinus presents a clinical challenge. A thorough evaluation of any potential contributing factors must be done in addition to an assessment of the adequacy of prior surgical treatment of the maxillary sinus. Beyond the middle meatal antrostomy, EMMM can be used to effectively address RCMS. In cases that fail EMMM, removal of the condemned mucosa to encourage auto-obliteration of the sinus can be considered.
Topics: Humans; Maxillary Sinus; Endoscopy; Maxillary Sinusitis; Chronic Disease; Anti-Bacterial Agents
PubMed: 36484283
DOI: 10.1097/MOO.0000000000000860 -
Archives of Craniofacial Surgery Jun 2023Midfacial fractures frequently involve the maxillary sinus, leading to maxillary sinus pathology. We aimed to examine the incidence and contributing factors of maxillary...
BACKGROUND
Midfacial fractures frequently involve the maxillary sinus, leading to maxillary sinus pathology. We aimed to examine the incidence and contributing factors of maxillary sinus pathology in patients who underwent open reduction and internal fixation (ORIF) for midfacial fractures.
METHODS
A retrospective analysis was conducted on patients who underwent ORIF for midfacial fractures at our department over the past 10 years. The incidence of maxillary sinus pathology was identified clinically and/or by computed tomography findings. Factors that significantly influenced the groups with and without maxillary sinus pathology were examined.
RESULTS
The incidence of maxillary sinus pathology in patients who underwent ORIF for midfacial fractures was found to be 11.27%, with sinusitis being the most common pathology. Maxillary sinus pathology was significantly associated with the presence of a blowout fracture involving both the medial and the inferior orbital walls. Factors such as sex, age, diabetes mellitus, hypertension, smoking, inflammatory disease, follow-up period, use of absorbable plates, and use of titanium plates did not have a significant impact on the development of maxillary sinus pathology.
CONCLUSION
The incidence of maxillary sinus pathology in patients who underwent ORIF for midfacial fractures was relatively low, and in most cases, it resolved without the need for specific treatment. Consequently, there may not be a significant need for concern regarding postoperative maxillary sinus pathology.
PubMed: 37415469
DOI: 10.7181/acfs.2023.00283 -
Romanian Journal of Ophthalmology 2023Odontogenic sinusitis is a well-known, but under-studied bacterial infection of the maxillary sinus that can extend to other sinuses, the orbit, or even the...
Odontogenic sinusitis is a well-known, but under-studied bacterial infection of the maxillary sinus that can extend to other sinuses, the orbit, or even the endocranium. We performed an observational retrospective study on the patients with odontogenic sinusitis treated in our hospital over a five-year period. We included patients over 18 years old diagnosed with odontogenic sinusitis and ocular complications and we excluded patients with ocular complications nonrelated to dental-originated sinusitis or patients with odontogenic sinusitis without orbital-ocular complications. We examined the charts of 46 patients. From the total number of patients with oculo-orbital complications generated by odontogenic sinusitis, only 7 were women. The mean age was 33,7 with a standard deviation of 15,7 years. The oculo-orbital complications were assessed according to the Chandler classification. The most frequent orbital complication was preseptal cellulitis followed by orbital cellulitis. All the patients were treated with antibiotic covering both anaerobic and aerobic bacteria and 40 of the patients in our study received surgical treatment. The outcomes were favorable for all the patients in our study with clinical resolution. The oculo-orbital complications of odontogenic sinusitis are severe because they can result in vision loss or other ocular sequelae. The bacteriological features of this sinusitis explain the special characteristics of this infection and can facilitate the extent of the infection to the orbit. Prompt intervention with antibiotics covering anaerobic and aerobic bacteria and surgery addressed to the affected sinus/ sinuses, the dental disease and the orbital pathology ensures a big success rate in the therapy of these complications.
PubMed: 37522025
DOI: 10.22336/rjo.2023.30 -
The Annals of Otology, Rhinology, and... Oct 2022To investigate the use of near-infrared (NIR) imaging as a tool for outpatient clinicians to quickly and accurately assess for maxillary sinusitis and to characterize...
OBJECTIVE
To investigate the use of near-infrared (NIR) imaging as a tool for outpatient clinicians to quickly and accurately assess for maxillary sinusitis and to characterize its accuracy compared to computerized tomography (CT) scan.
METHODS
In a prospective investigational study, NIR and CT images from 65 patients who presented to a tertiary care rhinology clinic were compared to determine the sensitivity and specificity of NIR as an imaging modality.
RESULTS
The sensitivity and specificity of NIR imaging in distinguishing normal versus maxillary sinus disease was found to be 90% and 84%, normal versus mild maxillary sinus disease to be 76% and 91%, and mild versus severe maxillary sinus disease to be 96% and 81%, respectively. The average pixel intensity was also calculated and compared to the modified Lund-Mackay scores from CT scans to assess the ability of NIR imaging to stratify the severity of maxillary sinus disease. Average pixel intensity over a region of interest was significantly different ( < .001) between normal, mild, and severe disease, as well as when comparing normal versus mild ( < .001, 95% CI 42.22-105.39), normal versus severe ( < .001, 95% CI 119.43-174.14), and mild versus severe ( < .001, 95% CI 41.39-104.56) maxillary sinus disease.
CONCLUSION
Based on this data, NIR shows promise as a tool for identifying patients with potential maxillary sinus disease as well as providing information on severity of disease that may guide administration of appropriate treatments.
Topics: Humans; Hyperplasia; Maxillary Sinus; Maxillary Sinusitis; Prospective Studies; Sensitivity and Specificity; Sinusitis; Tomography, X-Ray Computed
PubMed: 34823368
DOI: 10.1177/00034894211060623 -
American Journal of Rhinology & Allergy Jul 2022Implantological procedures aimed at rehabilitating upper jaw edentulous patients (dental implant placement and/or maxillary sinus grafting) can sporadically result in... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Implantological procedures aimed at rehabilitating upper jaw edentulous patients (dental implant placement and/or maxillary sinus grafting) can sporadically result in sinusitis. In these patients, endoscopic sinus surgery is the most commonly employed treatment, but clinical scenarios and comprehensive management strategies are extremely heterogeneous across studies.
OBJECTIVE
We sought to systematically define treatment strategies and related success rates for sinusitis following dental implantation, detailing different current treatment choices and concepts.
METHODS
Adopting a PRISMA-compliant review framework, systematic searches were performed in multiple databases using criteria designed to include all studies published until November 2020 focusing on the treatment of human sinusitis following dental implantation. We selected all original studies, excluding case reports, specifying treatment modalities with objective treatment success definitions. Following duplicate removal, abstract and full-text selection, and quality assessment, we reviewed eligible articles for treatment modalities and success rates, which were pooled in a random-effects meta-analysis.
RESULTS
Among 581 unique citations, eight studies (181 patients) were selected. Seven studies were retrospective case series. All studies relied on endoscopic sinus surgery, often coupled with intraoral accesses, and assessed therapeutic success endoscopically. The pooled treatment success rate was 94.7% (95% confidence interval, 91.5%-98%). Failures were treated in seven of 15 cases with further antibiotic therapies and in another seven cases with surgical revision. A single patient was lost to follow-up.
CONCLUSIONS
Endoscopic sinus surgery appears to be the most frequent treatment of choice for sinusitis following dental implantation, with excellent success rates. The protean clinical picture drawn from the selected studies calls for the standardization of diagnostics and definitions in this field to enable direct comparisons between the results of different studies. The role of postoperative antibiotic therapies, which have been employed unevenly across studies, should also be prospectively investigated.
Topics: Humans; Retrospective Studies; Sinusitis; Maxillary Sinus; Endoscopy; Anti-Bacterial Agents; Dental Implantation; Maxillary Sinusitis; Dental Implants
PubMed: 35244478
DOI: 10.1177/19458924221084484 -
Cureus Jan 2020Objectives Maxillary antroliths are calcified masses found within the maxillary sinus. The aim of this study was to investigate their presence in a sample of Lebanese...
Objectives Maxillary antroliths are calcified masses found within the maxillary sinus. The aim of this study was to investigate their presence in a sample of Lebanese population by means of digital panoramic radiographs. Material and methods In this study, 500 digital panoramic radiographs of Lebanese adult patients (281 females and 219 males) with a median age of 47.9±18.98 years were included and examined for maxillary antroliths. The statistical analysis of the data found was performed by IBM® SPSS® (IBM, Armonk, NY) version 20.0 for Windows. Results The sample investigated presented only three maxillary antroliths (0.6%). Among these, two were found in female patients and one in male; none of them was bilateral, one on the right side and two on the left side. No statistically significant relationships were observed with patients' gender and age. Conclusion Maxillary antroliths are rare entities detected accidentally on panoramic radiographs utilized frequently in dental clinics. In light of their possible association with chronic sinusitis, dentists should have a complete knowledge of their diagnosis.
PubMed: 32104623
DOI: 10.7759/cureus.6686 -
Acta Otorhinolaryngologica Italica :... Apr 2021
Topics: Dentists; Humans; Maxillary Sinus; Sinusitis
PubMed: 34060527
DOI: 10.14639/0392-100X-suppl.1-41-2021-12