Pathophysiology of current odontogenic maxillary sinusitis and endoscopic sinus surgery preceding dental treatment |
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| Authors: | Kiminori Sato Shun-ichi Chitose Kiminobu Sato Fumihiko Sato Takeharu Ono Hirohito Umeno |
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| Affiliation: | 1. Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan;2. Department of Otolaryngology-Head and Neck Surgery, Sato Clinic & Hospital, Oita, Japan;1. Department of Head and Neck Surgery, Miyagi Cancer Center, 47-1 Nodayama, Medeshima-Shiode, Natori 981-1293, Miyagi, Japan;2. Department of Rehabilitation, Miyagi Cancer Center, Natori, Miyagi, Japan;3. Department of Orthopaedic Surgery, Akaishi Hospital, Shiogama, Miyagi, Japan;4. Department of Physical Therapy, Yamagata Prefectural University of Health Sciences, Yamagata, Yamagata, Japan;5. Department of Head and Neck Medical Oncology, Miyagi Cancer Center, Natori, Miyagi, Japan;6. Department of Head and Neck Surgery, National Cancer Center East, Kashiwa, Chiba, Japan;1. Departments of Otolaryngology, Japanese Red Cross Society Himeji Hospital, 12-1 Shimoteno 1-Chome, Himeji City, Hyogo 670-8540, Japan;2. Department of Otolaryngology Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama City, Okayama 700-8558, Japan;3. Departments of Pathology, Japanese Red Cross Society Himeji Hospital, 12-1 Shimoteno 1-Chome, Himeji City, Hyogo 670-8540, Japan;4. Departments of Inspection technology, Japanese Red Cross Society Himeji Hospital, 12-1 Shimoteno 1-Chome, Himeji City, Hyogo 670-8540, Japan;1. Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Hospital, Busan, Republic of Korea;2. Department of Otorhinolaryngology-Head and Neck Surgery, The Dongnam Institute of Radiological and Medical Sciences (DIRAMS), Busan, Republic of Korea;3. Department of Otorhinolaryngology-Head and Neck Surgery, Dong-A University College of Medicine, Busan, Republic of Korea;4. Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi‐dong, Bundang‐gu, Seongnam 13620, Republic of Korea;1. Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho, Kita-ku, Okayama 700-8558, Japan;2. Department of Otolaryngology, Japanese Red Cross Society Himeji Hospital, Hyogo, Japan;3. Department of Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan;4. Department of Oral and Maxillofacial Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan;5. Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kumamoto University, Kumamoto, Japan;6. Department of Pathology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan;7. Division of Pathophysiology, Graduate School of Health Sciences Okayama University, Okayama, Japan;1. Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, YoshidaKonoecho, Sakyoku, Kyoto 650-8507, Japan;2. Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto 650-8501, Japan;3. Department of Otolaryngology, Shiga Medical Center for Children, Shiga 524-0022, Japan;1. Department of Otolaryngology Head and Neck Surgery, Kurashiki Central Hospital, Miwa 1-1-1, Kurashiki, Okayama 710-8602, Japan;2. Kurashiki Clinical Research Institute, Miwa 1-1-1, Kurashiki, Okayama 710-8602, Japan |
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| Abstract: | ![]()
ObjectiveThe successful management of odontogenic maxillary sinusitis (OMS) involves a combination of medical treatment with dental surgery and/or endoscopic sinus surgery (ESS). However, there is no consensus for the optimal timing of ESS. Although several studies have emphasized dental surgery as the primary treatment modality for OMS, there is recent evidence to suggest that ESS alone may be an effective treatment approach.The purpose of this study is to retrospectively investigate the pathophysiology of the current intractable OMS and the role ESS, especially ESS preceding dental treatment, plays in its pathophysiology.MethodsNinety-seven adults (60 males and 37 females, 48 ± 12 years) who underwent ESS for intractable OMS were retrospectively examined.ResultsIn a great deal of the cases (85 cases, 87.6%), causative teeth of OMS were periapical lesions after root canal treatment (endodontics). The root canal procedures were not sufficient; hence, the root-canal-treated teeth had periapical lesions causing OMS.In postoperative nasal endoscopy and cone-beam CT scans for all patients, the natural ostiums and the membranous portions of the maxillary sinuses were enlarged and the ostiomeatal complexes remained widely open. The ventilation and drainage of all patients’ maxillary sinuses seemed to be successfully restored.Temporary acute sinusitis recurrence after primary ESS for OMS was observed in 10 cases (11.8%) when the patients caught a cold. However, since the natural ostium and the membranous portion of the maxillary sinuses and the ostiomeatal complexes remained widely open, antibiotic administration alone without dental treatment cured the temporary acute sinusitis.Regarding the causative teeth (endodontic treated teeth), in 83 out of 85 cases (97.6%), causative teeth were able to be preserved with only antibiotic treatment and without dental retreatment. In two cases, extraction of the teeth was necessary because the teeth became mobile. Regarding the causative teeth after dental restoration, in 2 out of 2 cases (100%), causative teeth were able to be preserved with antibiotic treatment alone.ConclusionESS is highly indicated for OMS requiring surgery. The treatment results of intractable OMS are exceptionally good once the ventilation and drainage of the maxillary sinus is successfully restored after surgery. Consequently, ESS can be considered the first-line therapy for intractable OMS caused by root canal treatment (endodontics) and dental restoration, followed by close dental follow-up and dental treatment when necessary. |
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