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Treatment Strategy for Odontogenic Sinusitis.

Byung Joon Yoo¹, Seon Min Jung¹, Ha Na Lee¹

¹Department of Otolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea.

American Journal of Rhinology & Allergy

|July 30, 2020

Summary

Odontogenic sinusitis (OS) from dental issues can often be treated with dental care and medication. Smokers and those with severe sinus imaging findings may need early endoscopic sinus surgery (ESS).

Keywords:

chronic rhinosinusitis dental caries dental infection dental sinusitis dental treatment endoscopic sinus surgery odontogenic odontogenic sinusitis periapical abscess sinusitis

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Area of Science:

Otolaryngology
Endodontics
Oral Surgery

Background:

Odontogenic sinusitis (OS) management involves medical therapy, endoscopic sinus surgery (ESS), and dental treatment.
Dental caries and periapical abscesses are common causes of OS.

Purpose of the Study:

To determine if dental treatment alone can resolve OS caused by dental caries and periapical abscess.
To identify patient factors predicting the need for early surgical intervention.

Main Methods:

33 patients with OS due to dental caries/periapical abscess were included.
Patients received initial dental and medical management, excluding ESS.
Clinical parameters were compared between treatment success and failure groups.

Main Results:

67% of patients were successfully treated with dental and medical management alone.
33% of patients ultimately required ESS.
Smoking (OR 33.4) and high Lund-Mackay CT scores (OR 2.0) predicted the need for ESS.

Conclusions:

Dental and medical management are effective primary treatments for OS originating from dental caries and periapical abscess.
Early ESS is recommended for patients who smoke or present with severe sinus inflammation on CT scans.