Clinical aspects of odontogenic maxillary sinusitis: a case series

The incidence of odontogenic maxillary sinusitis (OMS) is unknown. Failure to address dental pathology causing sinusitis can lead to failure of medical and surgical treatments. The purpose of this article is to present an OMS patient series.

Retrospective review of prospectively accrued patients. Sinusitis guidelines were reviewed for OMS incidence and management. The clinical aspects of OMS in 21 patients diagnosed by sinus computed tomography (CT) scan over the last 30 months were assessed.

In our series the mean age was 53 years (range, 21-70 years), mean duration of symptoms was 2.6 years (range, 1 month to 15 years), rotten smell or bad taste was present in 10 of 21 (48%) patients, dental pain was present in 6 of 21 (29%) patients, and unilateral maxillary opacification was present in 12 of 23 (57%) patients. Dental pathology was not noted in 6 of 7 (86%) of pre-CT dental films and 14 of 21 (67%) of initial sinus CT reports but reevaluation of CT scans found dental pathology in all patients.

Dental pathology causing sinusitis was frequently missed on plain dental X-rays and CT scan reports. Dental pain and foul-smelling nasal discharge are present in less than one-half of patients and symptoms commonly persist for years. Otolaryngologists must have a high index of suspicion for an odontogenic cause of refractory maxillary sinusitis.