Predicting Odontogenic Sinusitis in Unilateral Sinus Disease: A Prospective, Multivariate Analysis.

Area of Science:

• Otorhinolaryngology
• Dental Medicine
• Radiology

Background:

• Odontogenic sinusitis (ODS) is a frequent cause of unilateral sinus disease (USD).
• ODS diagnosis is challenging due to nonspecific symptoms and subtle radiographic findings.
• It is underrepresented in the sinusitis literature.

Purpose of the Study:

• To identify sinonasal clinical variables predicting ODS in patients with unilateral maxillary sinus opacification on CT.
• To improve diagnostic accuracy for ODS.

Main Methods:

• A prospective cohort study of 131 patients with unilateral maxillary sinus opacification.
• Data collected included demographics, sinonasal symptoms, endoscopy findings, CT scans, and histopathology.
• Univariate and multivariate analyses compared patients with ODS and non-odontogenic disease.

Main Results:

• Middle meatal pus (OR=17.67), foul smell (OR=6.11), facial pressure (OR=3.55), and frontal opacification (OR=5.19) were associated with ODS.
• Sphenoid opacification was inversely related to ODS (OR=0.14).
• The study was adequately powered to detect significant differences.

Conclusions:

• Foul smell, ipsilateral facial pressure, middle meatal pus, and frontal sinus opacification are significant indicators of ODS.
• Sphenoid sinus opacification is inversely associated with ODS.
• These clinical variables aid in assessing the likelihood of an odontogenic source for sinusitis.