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Outcome of Concomitant Maxillary Sinusitis Following Surgical Treatment for Maxillary Medication-Related
Huixia Xu1, Ting Cao1, Jinyuan He1
1Resident, Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, People's Republic of China.
Background:
The incidence of medication-related osteonecrosis of the jaw (MRONJ) is increasing, and maxillary MRONJ is frequently complicated by maxillary sinusitis, which may lead to severe complications if not adequately controlled.
Purpose:
The purpose of the study was to evaluate the incidence and time to resolution of maxillary sinusitis in patients with MRONJ involving the posterior maxilla following surgical treatment and perioperative management and identify factors associated with the resolution process.
Study Design, Setting, And Sample:
This retrospective cohort study included subjects treated for MRONJ-associated maxillary sinusitis at Nanjing Stomatological Hospital between January 2013 and January 2025. Exclusion criteria included metastatic malignant tumors of the maxillofacial region, severe systemic disease contraindicating surgical treatment, and incomplete clinical data.
Predictor Variable:
The predictor variable was a set of heterogeneous factors including age, sex, MRONJ stage, primary disease, type and duration of antiresorptive therapy, preoperative grade of maxillary sinusitis, preservation of the maxillary sinus mucosa, maxillary sinus irrigation, and closure technique for oroantral communication.
Main Outcome Variable:
The primary outcome variable was time to resolution of maxillary sinusitis, defined as complete radiographic resolution of maxillary sinus inflammation.
Covariates:
N/A.
Analyses:
Kaplan-Meier analysis and Cox proportional hazards regression were used to assess factors associated with time to resolution (P < .05).
Results:
The sample included 28 subjects (mean age, 66.89 ± 10.99 years; seven male, 25%). During follow-up, 13 subjects (46.43%) achieved complete radiographic resolution. The 12-month cumulative incidence of resolution was 63.5%, with a median time to resolution of 9 months (interquartile range, 6.5 to 17.5 months). Kaplan-Meier analysis demonstrated a significant difference in resolution time according to preoperative sinusitis grade (P = .016). Cox regression identified preoperative sinusitis grade as an independent factor associated with delayed resolution (hazard ratio = 0.218; 95% CI, 0.056 to 0.851; P = .028).
Conclusion:
Surgical treatment combined with perioperative management was associated with radiographic resolution of MRONJ-associated maxillary sinusitis in more than half of the subjects within 12 months. A higher preoperative sinusitis grade was associated with delayed resolution.
