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Single-step surgical treatment of odontogenic maxillary sinusitis: A retrospective study of 98 cases
Authors:Fabio Costa  Enzo Emanuelli  Leonardo Franz  Alessandro Tel  Massimo Robiony
Affiliation:1. Maxillofacial Surgery Unit, Azienda Ospedaliero Universitaria of Udine, Udine, Italy;2. Department of Otorhinolaryngology and Otologic Surgery, Azienda Ospedaliera, Policlinico of Padova, Padova, Italy;3. Resident in Otorhinolaryngology, Azienda Ospedaliera, Policlinico of Padova, Padova, Italy;4. Resident in Maxillofacial Surgery Unit, Azienda Ospedaliero Universitaria of Udine, Udine, Italy;5. Maxillofacial Surgery, Chief of Maxillofacial Surgery Unit, Azienda Ospedaliero Universitaria of Udine, Department of Medical and Biological Science, University of Udine, Udine, Italy
Abstract:PurposeThe aim of this study was to review clinical and radiological presentation, surgery, and results of treatment in patients with chronic odontogenic maxillary sinusitis (OMS) treated with a single surgical procedure, including endoscopic sinus surgery (ESS) and oral surgical approaches to treat the odontogenic source of infection.Materials and methodsA retrospective case series analysis of 98 patients was performed. All the patients received ESS. 88 patients required oral surgical approaches.ResultsNasal symptoms were present in 58 patients (59.2%). Nasal endoscopy was positive in 65 patients (66.3%). A positive nasal endoscopy was significantly associated with nasal symptoms (p < 0.05). 60 patients (61.2%) had OMS of iatrogenic origin. Total opacification of the maxillary sinus was the most common radiological presentation (74.5%) and was significantly associated with nasal symptoms (p < 0.05). 91 patients (92.9%) had complete clinical and radiological resolution of the OMS.ConclusionsIatrogenic origin, sinonasal symptoms and positive clinical endoscopy are common in patients with OMS. Nasal symptoms were significantly associated with total maxillary sinus opacification and positive endoscopic clinical examination. Combining treatment of the odontogenic source of infection via an oral surgical approach and of the sinus inflammation by ESS appears to be sufficient for successfully treating patients with OMS.
Keywords:Corresponding author. Clinica di Chirurgia Maxillo-Facciale, Azienda Ospedaliero Universitaria, P.le S. Maria della Misericordia 15, 33100, Udine, Italy. Fax: +39 (0) 432559868.  Odontogenic maxillary sinusitis  Endoscopic sinus surgery  Odontogenic infection
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