scholarly journals Challenges in diagnosing odontogenic lesions in maxillary sinuses

2019 ◽  
Vol 74 (2) ◽  
pp. 1-5
Author(s):  
Katarzyna Dobroś ◽  
Joanna Zarzecka

Objectives: The study aimed to identify the patients with pathological lesions in the maxillary sinuses in which the reported symptoms might be indicative of odontogenic origin, as well as to establish specific causative risk factors promoting their development. Methods and Materials: The study covered 44 patients with suspected odontogenic maxillary sinusitis. Dental examination and Cone Bean Computed Tomography was completed. Their age ranged 19 - 69 years, mean age was 43 (SD = 13.9) years. Results: Out of 44 patients, 22 (50%) had non-odontogenic lesions in maxillary sinuses, while in 15 (34.1%) dental origin was established. In the remaining 7 (15.9%) patients, no pathological changes were found in the sinuses. A median of reported symptoms was 10 months (Q1 = 4, Q3 = 24). Reported complaints were not associated with the actual cause of pathological lesions. Conclusions: Odontogenic cause of the lesions in the sinuses should primarily be hypothesized, especially in the patients with long-term disease symptoms, also with regard to any unilateral inflammations.

2020 ◽  
Vol 48 (3) ◽  
pp. 143-153
Author(s):  
A. V. Zubova ◽  
N. I. Ananyeva ◽  
V. G. Moiseyev ◽  
I. K. Stulov ◽  
L. M. Dmitrenko ◽  
...  

We discuss the methodological advantages of using X-ray computed tomography (CT) for diagnosing chronic maxillary sinusitis (CMS) of various etiologies on skeletal samples. A CT examination of 20 crania from the Pucará de Tilcara fortress, Argentina (late 8th to 16th centuries AD), was carried out. Criteria for identifying CMS included osteitic lesions in the form of focal destruction, and thickened and sclerotized walls of maxillary sinuses. To determine the etiology of the disease, a tomographic and macroscopic examination of the dentition and bones of the ostiomeatal complex were performed, the presence or absence of facial injuries was assessed, and the co-occurrence of various pathologies was statistically evaluated. Five cases of CMS were identified. Four of these may be of odontogenic origin; in two cases, a secondary infection of the maxillary sinuses is possible. In one instance, the etiology was not determined. No indications of traumatic infection were found. Statistical analysis revealed a relationship of CMS with apical periodontitis and the ante-mortem loss of upper molars and premolars. An indirect symptom of CMS may be the remodeled bone tissue and porosity of the posterior surface of the maxilla.


Author(s):  
Massimo Galli ◽  
Giulia De Soccio ◽  
Fabrizio Cialente ◽  
Francesca Candelori ◽  
Francesca Romana Federici ◽  
...  

Unilateral chronic maxillary sinusitis is a possible complication of odontogenic disease or dental treatment and is mainly due to the development of an oroantral fistula (OAF). The management of chronic maxillary sinusitis of dental origin requires a combined treatment via endoscopic sinus surgery (ESS) and intraoral surgical treatment of the odontogenic source. The aim of this study is to present the results of our university hospital unit in the treatment and follow-up of a case series of 34 patients treated with combined surgical approach for chronic maxillary sinusitis of dental origin due to OAF. All patients were treated with ESS combined with an intraoral approach. No intraoperative or immediate postoperative complications were observed; nasal synechia was found in 3 patients (8.82%). The overall success rate after primary intervention was 94.12%; recurrence was observed in 2 cases (5.88%), both were suffering from diabetes mellitus and were tobacco smokers. Our results confirm that simultaneous surgery with a combination of an intraoral and endoscopic approach can be considered the best strategy for the long-term restoration of a normal sinonasal homeostasis in selected patients with chronic odontogenic sinusitis and OAF, guaranteeing an effective treatment with minimal complications in the short and long term.


2021 ◽  
Vol 10 (13) ◽  
pp. 2849
Author(s):  
Piotr Kuligowski ◽  
Aleksandra Jaroń ◽  
Olga Preuss ◽  
Ewa Gabrysz-Trybek ◽  
Joanna Bladowska ◽  
...  

Odontogenic infections can directly trigger maxillary sinusitis. CBCT is an excellent choice for precise examination of maxillary sinuses and hard tissues within the oral cavity. The objective of this retrospective and the cross-sectional study was to analyze the influence of odontogenic conditions on the presence and intensity of maxillary sinus mucous membrane thickening using CBCT imaging. Moreover, periodontal bone loss and anatomic relationship between adjacent teeth and maxillary sinuses were assessed to evaluate its possible impact on creating maxillary thickening. The study sample consisted of 200 maxillary sinuses of 100 patients visible on CBCT examination with a field of view of 13 × 15 cm. The presented study revealed a significant influence of periapical lesions, inappropriate endodontic treatment, severe caries, and extracted teeth on the presence of increased thickening of maxillary sinus mucous membrane. In addition, an increase in the distance between root apices and maxillary sinus floor triggered a significant reduction of maxillary sinus mucous membrane thickening. The presence of periodontal bone loss significantly increases maxillary sinus mucous membrane thickening.


1987 ◽  
Vol 28 (1) ◽  
pp. 31-34 ◽  
Author(s):  
C. Jensen ◽  
C. von Sydow

In order to analyze whether ultrasonography with a reasonable degree of confidence can replace radiography in the diagnosis of sinusitis, 138 patients with clinical signs of sinusitis were examined with both methods. It was found that maxillary sinus fluid was recognized ultrasonographically with a confidence that increased with the amount of fluid, judged from radiographic examinations. In a sub-group of 45 cases, fluid confirmed by maxillary sinus puncture was detected by ultrasonography in 35/45 sinuses (78%) and by radiology in 38/45 sinuses (84%). In patients with radiographically normal maxillary sinuses, the correlation to ultrasound was good. However, mucosal swelling and polyps or cysts observed at radiography were poorly demonstrated by ultrasonography. In addition, the ultrasound method was not reliable for frontal sinus diagnosis. It was concluded that ultrasonography can be recommended in maxillary sinusitis for follow-up of treatment and as a screening method before sinus radiography.


2021 ◽  
Vol 12 ◽  
Author(s):  
Ya-fei Qin ◽  
De-jun Kong ◽  
Hong Qin ◽  
Yang-lin Zhu ◽  
Guang-ming Li ◽  
...  

BackgroundChronic rejection characterized by chronic allograft vasculopathy (CAV) remains a major obstacle to long-term graft survival. Due to multiple complicated mechanisms involved, a novel therapy for CAV remains exploration. Although mesenchymal stromal cells (MSCs) have been ubiquitously applied to various refractory immune-related diseases, rare research makes a thorough inquiry in CAV. Meanwhile, melatonin (MT), a wide spectrum of immunomodulator, plays a non-negligible role in transplantation immunity. Here, we have investigated the synergistic effects of MT in combination with MSCs in attenuation of CAV.MethodsC57BL/6 (B6) mouse recipients receiving BALB/c mouse donor aorta transplantation have been treated with MT and/or adipose-derived MSCs. Graft pathological changes, intragraft immunocyte infiltration, splenic immune cell populations, circulating donor-specific antibodies levels, cytokine profiles were detected on post-operative day 40. The proliferation capacity of CD4+ and CD8+ T cells, populations of Th1, Th17, and Tregs were also assessed in vitro.ResultsGrafts in untreated recipients developed a typical pathological feature of CAV characterized by intimal thickening 40 days after transplantation. Compared to untreated and monotherapy groups, MT in combination with MSCs effectively ameliorated pathological changes of aorta grafts indicated by markedly decreased levels of intimal hyperplasia and the infiltration of CD4+ cells, CD8+ cells, and macrophages, but elevated infiltration of Foxp3+ cells. MT either alone or in combination with MSCs effectively inhibited the proliferation of T cells, decreased populations of Th1 and Th17 cells, but increased the proportion of Tregs in vitro. MT synergized with MSCs displayed much fewer splenic populations of CD4+ and CD8+ T cells, Th1 cells, Th17 cells, CD4+ central memory T cells (Tcm), as well as effector memory T cells (Tem) in aorta transplant recipients. In addition, the percentage of splenic Tregs was substantially increased in the combination therapy group. Furthermore, MT combined with MSCs markedly reduced serum levels of circulating allospecific IgG and IgM, as well as decreased the levels of pro-inflammatory IFN-γ, TNF-α, IL-1β, IL-6, IL-17A, and MCP-1, but increased the level of IL-10 in the recipients.ConclusionsThese data suggest that MT has synergy with MSCs to markedly attenuate CAV and provide a novel therapeutic strategy to improve the long-term allograft acceptance in transplant recipients.


2021 ◽  
Vol 11 (2) ◽  
pp. 118-122
Author(s):  
Marietta Sukhorukikh ◽  
Marina Kozlova ◽  
Ekaterina Gorbatova ◽  
Larisa Dzikovitskaya ◽  
Alexey Bashtovoy

The aim of the study was to assess the state of the clinical course of periodontal diseases in patients with postmenopausal osteoporosis (OP), depending on the long-term oral administration of various groups of bisphosphonates (BP). The study included 120 women aged 55–65 years with postmenopausal OP for at least three years who took complex antiosteoporetic therapy, including BP in tablet form. The dental examination included an examination of the oral cavity, the study of the pH of the oral fluid, the hygienic state of the mouth (the "Florida Probe" system). According to the results of the study, it was revealed that prolonged treatment of BP in tablets can provoke the development of inflammatory reactions in periodontal tissues. This phenomenon is associated with a shift in the pH of saliva to the acidic side, at which its buffer properties change.


1994 ◽  
Vol 111 (6) ◽  
pp. 781-786 ◽  
Author(s):  
George P. Katsantonis ◽  
William H. Friedman ◽  
Matthew Bruns

Intranasal sphenoethmoldectomy was originally used primarily for the provision of adequate drainage of acute and subacute bacterial sinusitis. However, the spectrum of inflammatory sinus disease has changed dramatically since the popularization of broad-spectrum antibiotics, and chronic hyperplastic rhinosinusitis has replaced acute sinusitis as the primary indication for ethmoidectomy. In such cases total or almost total disease removal is crucial to providing long-term drainage and ventilation. We describe several modifications of the Yankauer sphenoethmoldectomy technique that enable the sinus surgeon to provide clearance of disease and excellent drainage for all sinuses by complete marsupialization of the sphenoid, ethmoid, and maxillary sinuses. These modifications include (1) complete rather than partial removal of the middle turbinate. (2) extended middle meatal antrostomy with palatine bone resection to the pterygoid process with delineation of the inferior and medial orbital wall, and (3) Introduction of operative endoscopes as adjunctive tools in areas inaccessible to conventional visualization. The current technique and results in nearly 2000 procedures are described.


Neurosurgery describes the surgical treatment and management of various disease processes that target the brain, spinal cord, and peripheral nervous system. The specialty is wide and varied as increasing numbers of neurological conditions can now be improved following neurosurgery; for example, some types of epilepsy respond to the insertion of a vagal nerve stimulator, Parkinson’s disease symptoms can be diminished with a deep brain stimulator, and intractable back pain may be improved following spinal surgery. Practitioners must be equipped with the knowledge and skills to care for these patients and meet their immediate and long-term needs.


1989 ◽  
Vol 103 (6) ◽  
pp. 622-625 ◽  
Author(s):  
S. J. Gould ◽  
J. Graham

AbstractIn neonates, acquired subglottic stenosis (SGS) is the most serious long term complication of endotracheal intubation. In this case report, we describe the pathological changes in the larynx of a child who died two years after successful treatment, involving corrective surgery, for neonatally acquired SGS. Stenosis, due to dense fibrous connective tissue, was still present at death. However, there was evidence that there had been growth of the laryngeal cartilages. Disruption of the laryngeal cartilages was present anteriorly due to the antecedent surgery but major cricoid cartilage injury secondary to intubation was not seen. The crico-arytenoid joints demonstrated ankylosis and to this was attributed the abnormal quality of voice noted in the child at follow-up. The pathological changes are considered in relation to the pathology of endotracheal intubation and pathogenesis of acquired subglottic stenosis.


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