scholarly journals Role of Endoscopic Sinus Surgery and Dental Treatment in the Management of Odontogenic Sinusitis Due to Endodontic Disease and Oroantral Fistula

2021 ◽  
Vol 10 (12) ◽  
pp. 2712
Author(s):  
Anda Gâta ◽  
Corneliu Toader ◽  
Dan Valean ◽  
Veronica Elena Trombitaș ◽  
Silviu Albu
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Dental Treatment ◽  
Treatment Success ◽  
Sinus Surgery ◽  
Rank Test ◽  
Oroantral Fistula ◽  
Surgical Closure ◽  
Communication Time ◽  
Odontogenic Sinusitis ◽  
Mean Time

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.

Treatment Strategy for Odontogenic Sinusitis

2020 ◽  
pp. 194589242094696 ◽  
Author(s):  
Byung Joon Yoo ◽  
Seon Min Jung ◽  
Ha Na Lee ◽  
Hyung Gu Kim ◽  
Jae Ho Chung ◽  
...  
Keyword(s):  
Dental Caries ◽  
Medical Management ◽  
Tooth Extraction ◽  
Dental Treatment ◽  
Treatment Options ◽  
Trauma Surgery ◽  
Sinus Surgery ◽  
Clinical Parameters ◽  
Periapical Abscess ◽  
Odontogenic Sinusitis

Background The treatment options for odontogenic sinusitis (OS) include medical management including antibiotics and saline nasal irrigation, endoscopic sinus surgery (ESS), and dental treatment. Objective The purpose of this study was to evaluate whether OS caused by dental caries and periapical abscess can be cured by dental treatment alone and which patients should consider surgery early. Methods A total of 33 patients with OS caused by dental caries and periapical abscess were enrolled. Patients with OS caused by dental implants, trauma, surgery, or tooth extraction were excluded. All patients were initially treated with dental treatment and medical management without ESS. The patients were divided into two groups according to the results of dental treatment and multiple clinical parameters were compared between the two groups. Results Among the 33 enrolled patients, 22 patients (67%) were cured with dental and medical management, and 11 patients (33%) required ESS after the failure of dental and medical management. Based on the multivariate analysis results, patients who were smokers (OR 33.4) and had a higher Lund-Mackay score on CT (OR 2.0) required ESS after the failure of dental and medical treatment. Conclusions Two-thirds of the patients with OS caused by dental caries and periapical abscess were cured with dental treatment and medical management without ESS. We recommend dental treatment and medical management first in OS caused by dental caries and periapical abscess. However, we recommend early ESS in patients with smoking habits and severe CT findings of the sinus.

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
Keyword(s):  
Information Support ◽  
Sinus Surgery ◽  
Dental Disease ◽  
Oroantral Fistula ◽  
Dental Pathology ◽  
Number Of Patients ◽  
System Data ◽  
Odontogenic Sinusitis ◽  
The Uk ◽  
Age Range

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.

scholarly journals Premedication with clonidine before TIVA optimizes surgical field visualization and shortens duration of endoscopic sinus surgery - results of a clinical trial

2013 ◽  
Vol 51 (3) ◽  
pp. 259-264
Author(s):  
K. Wawrzyniak ◽  
K. Kusza ◽  
J.B. Cywinski ◽  
P.K. Burduk ◽  
W. Kazmierczak
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Systemic Blood Pressure ◽  
Sinus Surgery ◽  
Intraoperative Bleeding ◽  
Oral Clonidine ◽  
Hemodynamic Profile ◽  
Surgical Field ◽  
To Receive ◽  
Mean Time

Background: During functional endoscopic sinus surgery (FESS), intraoperative bleeding can significantly compromise visualization of the surgical field. Clonidine constricts peripheral blood vessels and reduces systemic blood pressure, which in combination decrease nasal mucosa blood flow. This dual effect can potentially reduce bleeding during FESS and stabilize the intraoperative hemodynamic profile of the patient. Aim: The aim of this prospective study was to assess if the quality of the surgical field visualization during FESS was improved when clonidine was used as a premedication agent. Methodology: A group of 44 patients undergoing FESS for chronic sinusitis and polyp removal were enrolled and randomly assigned to receive either oral clonidine or midazolam as preoperative premedication. During the operation, the quality of the surgical field was assessed and graded by the operating surgeon using the scale proposed by Boezaart. The evaluations were done during surgery at 15 minutes (K1), 30 minutes (K2), 60 minutes (K3) and 120 minutes (K4) after incision. Results: The duration of the surgical procedure was significantly shorter in the clonidine group: mean time of surgery: 80 vs. 96 min in the clonidine and midazolam groups, respectively. Also better quality of surgical field was observed at all time points in the clonidine group. Conclusion: Premedication with clonidine before FESS results in shortening of the surgical time and a better quality of the surgical field.

scholarly journals An observational study comparing the effect of sphenopalatine artery block on bleeding in endoscopic sinus surgery

2017 ◽  
Vol 3 (4) ◽  
pp. 1010
Author(s):  
M. N. Shankar ◽  
V. Saravana Selvan ◽  
Nigil Sreedharan
Keyword(s):  
Observational Study ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Rank Test ◽  
Time Interval ◽  
Cross Sectional ◽  
Nasal Sinus ◽  
Significance Level ◽  
Sphenopalatine Artery ◽  
Significant Difference

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">The use of the sphenopalatine artery block to reduce bleeding during FESS, has been a debatable issue. This cross sectional observational study aims to study whether sphenopalatine artery block has any significant effect on bleeding. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">55 patients coming to the ENT department of Stanley Medical College from 2015–2016 were included in this study. All patients had bilateral nasal sinus disease and endoscopic sinus surgery was performed on both sides. 20 minutes prior to surgery one side was chosen randomly and sphenopalatine artery block was administered via the greater palatine canal approach. A mixture of lignocaine (2%) and adrenaline (1:80000) was used for infiltration. The surgery was done in an alternating fashion where the surgeon would operate for 15 minutes on one side and then moved onto the other side. The field was graded using the Wormald Grading at 30 minute intervals. The results were tabulated and the Wilcoxon Signed Rank Test was done at each time interval to see if there was a statistically significant difference in the grades of bleeding on both sides at each time interval. SPSS version 22.0 was used to analyse the data. Significance level was fixed as 5% (α=0.05).  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">It was found that for each time interval up to 120 minutes there was a significant decrease in the bleeding on the blocked side. However after 120 minutes the bleeding on both sides appeared to be same. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Sphenopalatine artery block given prior to surgery will be effective in reducing bleeding in FESS for the first 2 hours after which the effect of the block wears away.</span></p>

scholarly journals Pathophysiology of current odontogenic maxillary sinusitis and endoscopic sinus surgery preceding dental treatment

2020 ◽  
Author(s):  
Kiminori Sato ◽  
Shun-ichi Chitose ◽  
Kiminobu Sato ◽  
Fumihiko Sato ◽  
Takeharu Ono ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Dental Treatment ◽  
Maxillary Sinusitis ◽  
Sinus Surgery

Optimal timing of endoscopic sinus surgery for odontogenic sinusitis

2019 ◽  
Vol 129 (9) ◽  
pp. 1976-1983 ◽  
Author(s):  
John R. Craig ◽  
Christopher I. McHugh ◽  
Zachary H. Griggs ◽  
Edward I. Peterson
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Optimal Timing ◽  
Odontogenic Sinusitis

Maxillary sinusitis of dental origin due to oroantral fistula, treated by endoscopic sinus surgery and primary fistula closure

2010 ◽  
Vol 124 (9) ◽  
pp. 986-989 ◽  
Author(s):  
J Hajiioannou ◽  
E Koudounarakis ◽  
K Alexopoulos ◽  
A Kotsani ◽  
D E Kyrmizakis
Keyword(s):  
Alveolar Bone ◽  
Treatment Approach ◽  
Maxillary Sinusitis ◽  
Case Series ◽  
Current Treatment ◽  
Sinus Surgery ◽  
Oroantral Fistula ◽  
Dental Origin ◽  
Odontogenic Sinusitis ◽  
Chronic Maxillary Sinusitis

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.

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