Analysis of maxillary sinusitis using computed tomography

Odontogenic maxillary sinusitis can be defined as sinusitis induced by a dental lesion. We examined the CT findings of 68 patients with maxillary sinusitis in order to differentiate between inflammation of sinus origin and inflammation of dental origin. Maxillary sinusitis was classified into four types according to clinical symptoms, history and conventional radiographic findings: type 1, simple sinusitis; type 2, odontogenic sinusitis; type 3, mixed sinusitis; type 4, slight sinus abnormality with a dental lesion. The relationship between the type of maxillary sinusitis and CT findings was analysed. Type 1 sinusitis exhibited severe pathological changes in both mucosa and bone which often extended into the nasal cavity and other paranasal sinuses. Type 2 sinusitis exhibited localized pathology on the unilateral antral floor. Type 3 sinusitis exhibited severe pathology characteristic of type 1 combined with type 2 sinusitis. Type 4 sinusitis could be differentiated by the CT findings into type 1 or type 2 sinusitis. The classification of sinusitis in this manner has implications for treatment planning, and CT should therefore be performed when conventional radiography does not provide sufficient information.