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Laryngoscope Investigative... Apr 2020Histopathology of the maxillary sinus mucosa with intractable odontogenic maxillary sinusitis (OMS) was investigated and the role endoscopic sinus surgery (ESS) plays in...
OBJECTIVE
Histopathology of the maxillary sinus mucosa with intractable odontogenic maxillary sinusitis (OMS) was investigated and the role endoscopic sinus surgery (ESS) plays in its pathophysiology was clarified.
STUDY DESIGN
Histopathological analysis of the OMS mucosa.
METHODS
Surgical specimens were obtained from 20 patients who underwent ESS for intractable OMS. For rigid endoscopic observation of the mucosae, a 70° rigid endoscope 4 mm in diameter with an attached high definition surgical camera was used. Histopathological analyses of the maxillary sinus mucosa were conducted by light and scanning electron microscopy.
RESULTS
All the maxillary sinuses were filled, not with viscous, but with purulent secretions. The high-definition camera showed that the maxillary sinus mucosa had gyrus-like appearance. Light microscopic histopathological studies revealed that the surface of the maxillary sinus mucosa was convoluted. Light and scanning electron microscopic histopathological studies revealed that the ciliated cells of the epithelium had not decreased and their goblet cells were not hypertrophic, indicating that the damage of the ciliated columnar epithelium was not severe and they were not injured irreversibly.
CONCLUSION
The ciliated columnar epithelium with intractable OMS was not severely damaged and not irreversibly injured. Hence, the pathophysiology of intractable OMS is one of the reasons why ESS is highly indicated for maxillary sinusitis requiring surgery and the treatment results are exceptionally good when the ventilation and drainage of the maxillary sinus is successfully restored after surgery.
LEVEL OF EVIDENCE
NA.
PubMed: 32337350
DOI: 10.1002/lio2.376 -
International Journal of Oral Science Feb 2024Odontogenic maxillary sinusitis (OMS) is a subtype of maxillary sinusitis (MS). It is actually inflammation of the maxillary sinus that secondary to adjacent infectious... (Review)
Review
Odontogenic maxillary sinusitis (OMS) is a subtype of maxillary sinusitis (MS). It is actually inflammation of the maxillary sinus that secondary to adjacent infectious maxillary dental lesion. Due to the lack of unique clinical features, OMS is difficult to distinguish from other types of rhinosinusitis. Besides, the characteristic infectious pathogeny of OMS makes it is resistant to conventional therapies of rhinosinusitis. Its current diagnosis and treatment are thus facing great difficulties. The multi-disciplinary cooperation between otolaryngologists and dentists is absolutely urgent to settle these questions and to acquire standardized diagnostic and treatment regimen for OMS. However, this disease has actually received little attention and has been underrepresented by relatively low publication volume and quality. Based on systematically reviewed literature and practical experiences of expert members, our consensus focuses on characteristics, symptoms, classification and diagnosis of OMS, and further put forward multi-disciplinary treatment decisions for OMS, as well as the common treatment complications and relative managements. This consensus aims to increase attention to OMS, and optimize the clinical diagnosis and decision-making of OMS, which finally provides evidence-based options for OMS clinical management.
Topics: Humans; Maxillary Sinusitis; Consensus; Maxillary Sinus; Odontogenesis; Rhinosinusitis
PubMed: 38302479
DOI: 10.1038/s41368-024-00278-z -
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 -
Imaging Science in Dentistry Jun 2022This study developed a convolutional neural network (CNN) model to diagnose maxillary sinusitis on panoramic radiographs (PRs) and cone-beam computed tomographic (CBCT)...
PURPOSE
This study developed a convolutional neural network (CNN) model to diagnose maxillary sinusitis on panoramic radiographs (PRs) and cone-beam computed tomographic (CBCT) images and evaluated its performance.
MATERIALS AND METHODS
A CNN model, which is an artificial intelligence method, was utilized. The model was trained and tested by applying 5-fold cross-validation to a dataset of 148 healthy and 148 inflamed sinus images. The CNN model was implemented using the PyTorch library of the Python programming language. A receiver operating characteristic curve was plotted, and the area under the curve, accuracy, sensitivity, specificity, positive predictive value, and negative predictive values for both imaging techniques were calculated to evaluate the model.
RESULTS
The average accuracy, sensitivity, and specificity of the model in diagnosing sinusitis from PRs were 75.7%, 75.7%, and 75.7%, respectively. The accuracy, sensitivity, and specificity of the deep-learning system in diagnosing sinusitis from CBCT images were 99.7%, 100%, and 99.3%, respectively.
CONCLUSION
The diagnostic performance of the CNN for maxillary sinusitis from PRs was moderately high, whereas it was clearly higher with CBCT images. Three-dimensional images are accepted as the "gold standard" for diagnosis; therefore, this was not an unexpected result. Based on these results, deep-learning systems could be used as an effective guide in assisting with diagnoses, especially for less experienced practitioners.
PubMed: 35799961
DOI: 10.5624/isd.20210263 -
Journal of Clinical Medicine Aug 2023(1) Background: The demands of patients for aesthetic and functional rehabilitation of edentulous areas led to the use of dental implants as therapeutic means on an... (Review)
Review
(1) Background: The demands of patients for aesthetic and functional rehabilitation of edentulous areas led to the use of dental implants as therapeutic means on an increasingly large scale. This aspect determined the appearance of some infectious pathologies with a peri-implant starting point that can be complicated by various sinus diseases. The purpose of this review article is to synthesize the existing information in the specialized literature regarding the existing correlations between peri-implant and maxillary sinusitis. (2) Methods: The articles published in five databases were researched using different combinations of search terms. We selected 12 articles from the 250 found, by applying the inclusion and exclusion criteria and removing duplicates. (3) Results: We analyzed the included studies and we found that all of them reported a positive correlation between maxillary sinusitis and peri-implant infectious diseases. There are also reported other pathologies with a peri-implant infectious disease as a starting point such as abscesses, oro-antral communications, or foreign body reactions due to implant or bone graft materials migration. (4) Conclusions: This scoping review highlighted the existence of correlations between peri-implant and sinus pathology and the importance of preventing peri-implant diseases of an infectious nature to avoid the occurrence of these complications.
PubMed: 37568461
DOI: 10.3390/jcm12155059 -
BMJ (Clinical Research Ed.) Sep 1992
Topics: Endoscopy; Humans; Maxillary Sinusitis; Predictive Value of Tests
PubMed: 1393107
DOI: 10.1136/bmj.305.6855.662 -
CMAJ : Canadian Medical Association... Apr 2019
Topics: Amphotericin B; Antifungal Agents; Blindness; Brain Diseases; Debridement; Exophthalmos; Eye Diseases; Fatal Outcome; Female; Humans; Magnetic Resonance Imaging; Maxillary Sinusitis; Middle Aged; Mucormycosis; Optic Neuritis
PubMed: 31015350
DOI: 10.1503/cmaj.181210 -
Australian Dental Journal Sep 2014Rhinosinusitis is a very common condition which is normally readily recognizable. Given the intimate anatomic relationship between the antrum and the posterior maxillary... (Review)
Review
Rhinosinusitis is a very common condition which is normally readily recognizable. Given the intimate anatomic relationship between the antrum and the posterior maxillary teeth, maxillary sinusitis can present as odontalgia. Distinguishing between odontogenic orofacial pain and pain associated with maxillary sinusitis is important to prevent unnecessary dental intervention and to direct patients to medical colleagues. Conversely, odontogenic infection can spread to involve the antrum, termed odontogenic sinusitis, or maxillary sinusitis of dental origin. Odontogenic sinusitis accounts for about 10-40% of all cases of sinusitis, and usually requires combined dental and medical treatment. Maxillary sinusitis can also be a complication of exodontia, resulting from tuberosity fractures, displaced teeth or root fragments and the creation of oroantral communications and fistulae. Dental implants and endodontic materials can also impinge on the maxillary sinus, and are rare causes of sinusitis. Often it is stated that rhinosinusitis may contribute to a halitosis complaint, and widely used diagnostic protocols for rhinosinusitis sometimes list halitosis as a minor criterion. However, gold standards in halitotosis research such as organoleptic assessment or gas chromatography have not been used to validate a correlation between objective (genuine) halitosis and sinusitis. The pathophysiology of this mechanism is unclear, and the relative importance of this alongside other causes of extraoral halitosis is debated.
Topics: Dental Implants; Diagnosis, Differential; Female; Halitosis; Humans; Maxillary Sinus; Maxillary Sinusitis; Oral Medicine; Oroantral Fistula; Rhinitis; Tooth Extraction; Toothache
PubMed: 24861778
DOI: 10.1111/adj.12193 -
Oral and Maxillofacial Surgery Clinics... Nov 2020Endoscopic surgery on the maxillary sinus has experienced significant advances in technique and approaches since the maxillary antrostomy was introduced in the 1980s.... (Review)
Review
Endoscopic surgery on the maxillary sinus has experienced significant advances in technique and approaches since the maxillary antrostomy was introduced in the 1980s. Disease processes that previously required open surgical approaches to the maxillary sinus can now be treated endoscopically while preserving form and function of the sinus and without injuring the maxillary sinus mucosa or disrupting normal mucociliary clearance. Understanding the techniques described in this article will allow surgeons to appropriately plan treatment strategies for patients with a variety of maxillary sinus diseases from dentoalveolar origin.
Topics: Chronic Disease; Endoscopy; Humans; Maxillary Sinus; Maxillary Sinusitis
PubMed: 32891537
DOI: 10.1016/j.coms.2020.07.011 -
The Laryngoscope Oct 2021Acute rhinosinusitis is a frequent common cold-related complication in children. Despite the need for appropriate treatment, its underlying microbiology remains unclear....
OBJECTIVES/HYPOTHESIS
Acute rhinosinusitis is a frequent common cold-related complication in children. Despite the need for appropriate treatment, its underlying microbiology remains unclear. This study aimed to investigate the microbiology of acute rhinosinusitis in children.
STUDY DESIGN
Prospective non controlled study.
METHODS
Thirty-one pediatric acute maxillary sinusitis patients with severe symptoms were assessed. The subjects were 17 males and 14 females aged 5 to 14 years (mean age, 9.1 years). Maxillary sinus aspirates were collected and cultured, with subsequent viral and bacterial polymerase chain reaction (PCR) analysis. Bacteria were analyzed using culturing and PCR, and viruses were analyzed using PCR. The PCR kits used identify 18 types of respiratory viruses and 13 types of bacteria.
RESULTS
At least one pathogen was detected in 30 of 31 aspirates (97%) using PCR, and none of the aspirates contained respiratory viruses alone. Ten aspirates (32%) contained both viruses and bacteria. The most common viruses detected were rhinovirus (13%) and influenza virus (10%). The most common bacteria were Haemophilus influenzae (45%), Streptococcus pneumoniae (32%), Moraxella catarrhalis (16%), and Chlamydophila pneumoniae (13%). Bacteria were found in 21 of 31 cases (68%) via bacterial culturing. Culturing revealed that H influenzae was the most common pathogen (42%).
CONCLUSIONS
In pediatric acute maxillary sinusitis, respiratory bacteria were detected in 65% of the sinus aspirates and both bacteria and viruses in 32%. The most common viruses were rhinovirus and influenza virus, and the most common bacteria were H influenzae and S pneumoniae. Viral and bacterial PCR is useful for accurately investigating the microbiology in pediatric sinusitis.
LEVEL OF EVIDENCE
3 Laryngoscope, 131:E2705-E2711, 2021.
Topics: Acute Disease; Adolescent; Child; Child, Preschool; Female; Humans; Male; Maxillary Sinusitis; Polymerase Chain Reaction; Prospective Studies
PubMed: 33939189
DOI: 10.1002/lary.29564