Evidence of an increase in the incidence of odontogenic sinusitis over the last decade in the UK

2011 ◽  
Vol 126 (1) ◽  
pp. 43-46 ◽  
Author(s):  
E Hoskison ◽  
M Daniel ◽  
J E Rowson ◽  
N S Jones

AbstractBackground:Dental disease is a recognised cause of sinusitis. We perceived an increased incidence of sinusitis secondary to dental disease in recent years. This study reviews the incidence of odontogenic sinusitis, its clinical features and treatment.Methods:Medical records of patients with odontogenic sinusitis were identified using the senior author's clinical database and Hospital Information Support System data (January 2004 to December 2009).Results:Twenty-six patients were identified, nine females and 17 males (age range, 17–73 years). Rhinorrhoea and cacosmia were the commonest symptoms (81 and 73 per cent, respectively), with presence of pus the commonest examination finding (73 per cent). Causative dental pathology included periapical infection (73 per cent), oroantral fistula (23 per cent) and a retained root (4 per cent). In all 26 cases, treatment resulted in complete resolution of symptoms; 21 (81 per cent) required sinus surgery. The number of patients with odontogenic sinusitis undergoing surgery has steadily increased, from no cases in 2004 to 10 in 2009 (accounting for 8 per cent of all patients requiring sinus surgery). Reduced access to dental care may be responsible.Conclusion:The incidence of odontogenic sinusitis appears to be increasing. The importance of assessing the oral cavity and dentition in patients with rhinosinusitis is therefore emphasised.

2021 ◽  
Vol 10 (12) ◽  
pp. 2712
Author(s):  
Anda Gâta ◽  
Corneliu Toader ◽  
Dan Valean ◽  
Veronica Elena Trombitaș ◽  
Silviu Albu

Background: Odontogenic sinusitis (ODS) is frequently encountered in ENT practice; however, there are no guidelines regarding its management. This study aims to analyse the results of endoscopic sinus surgery versus dental treatment in ODS. Additionally, we aim to demonstrate the benefit of associating endoscopic sinus surgery (ESS) to surgical closure of chronic oroantral fistulas (OAF) by comparing mean time to healing in patients who opted or not for concurrent ESS. Methods: Records of patients with ODS were reviewed. Group one consisted of patients with ODS caused by periapical pathology undergoing either endoscopic sinus surgery (ESS) or dental treatment. Resolution of ODS was considered treatment success and was compared between the two treatment strategies. Group two included patients with ODS and associated chronic oroantral communication. Time to healing was compared between patients undergoing OAF closure alone versus patients receiving associated ESS, using the Log-Rank test to correlate Kaplan–Meier curves. Results: 25 patients from a total of 45 in group one underwent dental treatment alone, and 20 opted for exclusive ESS treatment. The failure rate was 40% for patients treated with ESS compared to 4% (one patient) for dental treatment. ODS resolved in all patients in the second group, but the mean time to healing was half (10 days) when ESS was complementary to OAF closure. Conclusion: The present study represents the first estimator of the role ESS plays in OAF treatment. Nonetheless, it provides proof of the importance of first addressing dental problems in odontogenic sinusitis.


Author(s):  
Manish Munjal ◽  
Suneet Sethi ◽  
Anurag Chowdhary ◽  
Shubham Munjal ◽  
Ananya Sood ◽  
...  

Background: The demographic profile of patients with Sphenoiditis undergoing surgical intervention, in the state of Punjab was studied. The emphasis was on the age, gender and clinical presentation in this prospective study.Methods: There were 75 patients of  sphenoethmoidal recess pathology with sphenoditis, who were selected from the Rhinology clinics of Otorhinolaryngology and head Neck services of  Dayanand Medical College and Hospital  Ludhiana , in a period one and a half years (November 2002 to October 2004). All patients were taken up for Functional endoscopic sinus surgery of the sphenoid  sinus surgery with sphenoidotomy.Results: The age range of subjects with sphenoiditis was between 12 years to 70 years. The mean age was 38.13 years. The maximum number of patients were in 19-30 years age group and the minimum in 31-40 years age group. Males outnumbered the females by a ratio of 1.7:1. The most common was posterior nasal drip (69.33% cases) behind the Eustachian tube and the least common complaint was diplopia (5.33% cases. Ocular involvement was observed in 32%. The right eye was more frequently involved (17.33%) as compared to the left (12%).Conclusions: Patients with Sphenoid sinusitis were seen in the broad age range from 19 to 30 years with a male predominance. Posterior nasal discharge behind the Eustachian tube, rather than the typical occipital ache was the primary complaint .Right sided eye involvement with ptosis and lateral rectus palsy were commonly noted. 


2010 ◽  
Vol 124 (9) ◽  
pp. 986-989 ◽  
Author(s):  
J Hajiioannou ◽  
E Koudounarakis ◽  
K Alexopoulos ◽  
A Kotsani ◽  
D E Kyrmizakis

AbstractAim:To present the current treatment approach for oroantral fistula causing maxillary sinusitis.Design:Case series. Four cases of oroantral fistula (diameters: 6, 9, 11 and 13 mm) due to chronic maxillary sinusitis were treated by excision of all diseased oroantral fistula tissue, followed by endoscopic creation of a large middle antrostomy and closure of the fistula using buccal flaps. A synthetic surgical glue and local alveolar bone were used.Results:Patients were followed up for six months to three years; all were considered cured.Conclusion:Most surgeons use buccal or palatal flaps, combined with the Caldwell–Luc procedure, to treat chronic odontogenic sinusitis and to repair fistulae more than 5 mm in diameter. This study supports the hypothesis that an endoscopic technique could be successfully used in patients with oroantral fistula causing chronic maxillary sinusitis of dental origin, instead of the Caldwell–Luc procedure, at least in patients with a small to medium-sized oroantral fistula.


Esculapio ◽  
2020 ◽  
Vol 16 (03, july 2020-Septmber 2020) ◽  
Author(s):  
Damish Arsalan ◽  
◽  
Sarwat Hassan Syed ◽  
Ghulam Murtaza ◽  
Mohammad Qamar Nasir ◽  
...  

Objectives: To determine the frequency of intranasal synechiae formation between lateral nasal wall and nasal septum after (ESS) Endoscopic Sinus Surgery among patients with Sino nasal Polyposis Methods: After obtaining approval from the ethical committee of our Hospital, a total number of 150 subjects fulfilling the study criteria were recruited in the research which was conducted in the department of Otorhinolaryngology, Services Hospital, Lahore. Demographic information (name, age, gender, contact details) was also obtained were included in this study. All the patients underwent ESS and were followed up post operatively at the end of 1st, 2nd, 3rd and 4th weeks respectively, to observe the formation of synechiae. Results: Age range in this study was between 21-40 years out of which a small number of patients were < 20 years old. Mean age of the patients was 35.30±10.54 years. Male patients were 80 (53.3%) while female patients were 70 (46.7%). Intranasal Synechiae formation was observed in 28 patients (18.7%). Conclusion: Intranasal Synechiae formation between lateral nasal wall and nasal septum was found in 18.4% of the patients after endoscopic sinus surgery. Keywords: Sino nasal polyposis, ESS, Intranasal Synechiae Formation


Author(s):  
R.A. Larin ◽  
◽  
D.D. Smirnova ◽  
S.V. Krasilnikova ◽  
A.A. Mhitaryan ◽  
...  

In recent years, against the backdrop of actively developing technologies in therapeutic and surgical stomatology, as well as endoscopic technologies in ENT practice, there has been an increase in the number of patients with various, including previously unobserved forms of odontogenic sinusitis (OS). Аccording to various data, from 5 to 30% of all cases of chronic rhinosinusitis are some odontogenic forms. Their specific gravity in the structure of the pathology of ENT hospitals is also growing. Accordingly, the number of surgical interventions is also increasing, which, in turn, necessitates a unification of indications for surgical interventions for some form of odontogenic sinusitis and, especially, in preparation for dental implantation. In the latter case, situations are not uncommon when the patient is referred to the maxillary sinus surgery proactively, “just in case”, which is unacceptable. This leads to the appearance of neglected, chronic forms, what is called "difficult-to-treat rhinosinusitis." The odontogenic (phlogogenic) reasons may include: foreign bodies of the sinus, complicated periodontitis, the consequences of sinus lifting, implantation, etc. It is necessary to study and specify the leading ones in each patient, which is important for building a competent medical strategy. Not all issues of diagnosis and treatment of odontogenic sinusitis, preparation for dental implantation are regulated by legal documents (standards, clinical guidelines). In the most difficult situations, collegial decision-making with the participation of all interested specialists is necessary. The number of diagnostic errors is increasing, especially in preparation for dental implantation and differential diagnosis of odontogenic and rhinogenic forms of sinusitis. At the same time, the bulk of such errors are allowed when interpreting data from radiation studies, or when prescribing radiation studies in the wrong format (MRI, radiography). All this determines the relevance of this study


2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii312-iii312
Author(s):  
Donald C Macarthur ◽  
Conor Mallucci ◽  
Ian Kamaly-Asl ◽  
John Goodden ◽  
Lisa C D Storer ◽  
...  

Abstract Paediatric Ependymoma is the second most common malignant brain tumour of childhood with approximately 50% of cases recurring. It has been described as a “surgical” disease since patients who have undergone a gross total surgical resection (GTR) have a better prognosis than those who have a subtotal resection (STR). Analysis of the UKCCSG/SIOP 1992 04 clinical trial has shown that only 49% of cases had a GTR, with 5-year survival rates for STR of 22–47% and GTR of 67–80%. As part of the SIOP II Ependymoma trial the UK established a panel of experts in the treatment of Ependymoma from Neuro-oncology, Neuro-radiology and Neuro-surgery. Meeting weekly, cases are discussed to provide a consensus on radiological review, ensuring central pathological review, trial stratification and whether further surgery should be advocated on any particular case. Evaluation of the first 68 UK patients has shown a GTR in 47/68 (69%) of patients and STR in 21/68 (31%) of patients. Following discussion at EMAG it was felt that 9/21 (43%) STR patients could be offered early second look surgery. Following this 2nd look surgery the number of cases with a GTR increased to 56/68 (82%). There has been a clear increase in the number of patients for whom a GTR has been achieved following discussion at EMAG and prior to them moving forwards with their oncological treatment. This can only have beneficial effects in decreasing their risk of tumour recurrence or CSF dissemination and also in reducing the target volume for radiotherapy.


2021 ◽  
pp. 146531252110216
Author(s):  
Annabelle Carter ◽  
Susan Stokes

Objective: To identify the number of companies providing Do-It-Yourself (DIY) orthodontics and explore information available on websites for DIY brace providers operating in the UK. Design: Web search and review of websites providing DIY braces. Setting: Leeds, UK. Methods: A Web search was completed in November 2020 and April 2021 of all companies providing DIY braces for UK consumers. Each website was evaluated, and the following data collected: name; year started operating; costs; process; involvement of a dental professional; average ‘treatment’ length; retention; consent process; information on risks and benefits; aligner material; social media presence; age suitability; and consumer ratings on Trustpilot. Quality of website information was assessed via the DISCERN tool. Results: Seven DIY orthodontic companies were operating in the UK. Websites reviewed revealed the following: product costs were in the range of £799–£1599, ‘treatment’ length quotes were in the range of 4–12 months; Trustpilot reviews were in the range of 1.6–4.8 stars; and websites claimed their aligners were suitable for individuals with an age range of 12–18 years. Quality of content regarding risks described on websites varied, and there was limited information regarding involvement of a dental professional. Quality of websites information scored ‘poor’ or ‘very poor’ on the DISCERN scoring. Conclusions: There has been an increase in the number of DIY orthodontic companies operating in the UK over the last three years. There is a need to determine whether these products constitute dental treatment in their own right. If so, it is crucial to ensure these are regulated appropriately with adequate information available to satisfy informed consent and have greater transparency over dental professional involvement to safeguard the public.


Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 324
Author(s):  
Ho-Seok Oh ◽  
Sung-Kyu Kim ◽  
Hyoung-Yeon Seo

To investigate the incidence and characteristics of osteoporosis and osteoporotic fractures in Korea, we used the Health Insurance Review and Assessment Service (HIRA) database. Patients over 50 years old, who were diagnosed or treated for osteoporosis and osteoporotic fractures in all hospitals and clinics, were analyzed between 1 January 2009 and 31 December 2017 by using the HIRA database that contains prescription data and diagnostic codes. These data were retrospectively analyzed by decade and age-specific and gender-specific incidents in each year. We also evaluated other characteristics of patients including medication state of osteoporosis, primary used medical institution, regional-specific incidence of osteoporosis, and incidence of site-specific osteoporotic fractures. The number of osteoporosis patients over 50 years old, as diagnosed by a doctor, steadily increased from 2009 to 2017. The number of osteoporosis patients was notably greatest in the 60′s and 70′s age groups in every study period. Patients undergoing treatment for osteoporosis increased significantly (96%) from 2009 to 2017. Among the patients diagnosed with osteoporosis, the proportion who experienced osteoporotic fracture increased gradually (60%) from 2009 to 2017. The number of patients with osteoporotic fractures of the spine and hip was highest in the 70 to 90 age range, and the number of patients with osteoporotic fractures in the upper and lower extremities was highest in the 50 to 70 age range. Understanding the trends of osteoporosis in Korea will contribute to manage the increased number of patients with osteoporosis and osteoporotic fractures.


2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Ahmed Gamal Khafagy ◽  
Mohamed El-Begermy ◽  
Marwa Mohamed El-Begermy ◽  
Pretty O. Afifi

Abstract Background This study aims to compare the graft uptake rate and hearing improvement of fat graft versus inlay butterfly tragal cartilage in the repair of perforations in chronic otitis media mucosal in adults. In this retrospective study, twenty-eight patients were included with small dry anteroinferior tympanic membrane perforations (less than 1/3 of the tympanic membrane). The age range was 18 to 44 years old. Myringoplasty was done under general anesthesia for 8 patients with a fat graft (FG) and 20 patients with inlay butterfly cartilage graft (IBCG). Six months postoperatively, a follow-up evaluation was done for successful graft uptake and hearing outcomes. Results The success rate of graft uptake in the first group (fat graft) was 6/8 cases (75%) while in the second group (IBCG) was 19/20 (95%) with no statistically significant difference (P = 0.0148). Also, there was no statistical difference between the two groups as regards postoperative ABG, improvement changes in ABG, and number of patients with improved hearing. Conclusions Inlay butterfly cartilage graft is a useful graft in repairing small tympanic membrane perforations as regard graft take and hearing outcomes.


2021 ◽  
Vol 10 (5) ◽  
pp. 1067
Author(s):  
Arne Kienzle ◽  
Lara Biedermann ◽  
Evgeniya Babeyko ◽  
Stephanie Kirschbaum ◽  
Georg Duda ◽  
...  

Due to the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic, a large number of elective knee replacement procedures had to be postponed in both early and late 2020 in most western countries including Germany and the UK. It is unknown how public interest and demand for total knee arthroplasties was affected. Public interest in knee pain, knee osteoarthritis and knee arthroplasty in Germany and the UK was investigated using Google Trend Analysis. In addition, we monitored for changes in patient composition in our outpatient department. As of early March in Germany and of late March in the UK, until the lockdown measures, a 50 to 60% decrease in relative search frequency was observed in all categories investigated compared to the beginning of the year. While public interest for knee pain rapidly recovered, decreased interest for knee osteoarthritis and replacement lasted until the easing of measures. Shortly prior to and during the first lockdown mean search frequency for knee replacement was significantly decreased from 39.7% and 36.6 to 26.9% in Germany and from 47.7% and 50.9 to 23.7% in the UK (Germany: p = 0.022 prior to lockdown, p < 0.001 during lockdown; UK: p < 0.0001 prior to and during lockdown). In contrast, mean search frequencies did not differ significantly from each other for any of the investigated time frames during the second half of 2020 in both countries. Similarly, during the first lockdown, the proportion of patients presenting themselves to receive primary knee arthroplasty compared to patients that had already undergone knee replacement declined markedly from 64.7% to 46.9%. In contrast, patient composition changed only marginally during the lockdown measures in late 2020 in both Germany and the UK. We observed a high level of public interest in knee arthroplasty despite the ongoing pandemic. The absence of a lasting decline in interest in primary knee arthroplasty suggests that sufficient symptom reduction cannot be achieved without surgical care for a substantial number of patients.


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