School of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Int Forum Allergy Rhinol. 2011 Sep-Oct;1(5):409-15. doi: 10.1002/alr.20058. Epub 2011 Aug 18.
The incidence of odontogenic maxillary sinusitis (OMS) is unknown. Failure to address dental pathology causing sinusitis can lead to failure of medical and surgical treatments. The purpose of this article is to present an OMS patient series.
Retrospective review of prospectively accrued patients. Sinusitis guidelines were reviewed for OMS incidence and management. The clinical aspects of OMS in 21 patients diagnosed by sinus computed tomography (CT) scan over the last 30 months were assessed.
In our series the mean age was 53 years (range, 21-70 years), mean duration of symptoms was 2.6 years (range, 1 month to 15 years), rotten smell or bad taste was present in 10 of 21 (48%) patients, dental pain was present in 6 of 21 (29%) patients, and unilateral maxillary opacification was present in 12 of 23 (57%) patients. Dental pathology was not noted in 6 of 7 (86%) of pre-CT dental films and 14 of 21 (67%) of initial sinus CT reports but reevaluation of CT scans found dental pathology in all patients.
Dental pathology causing sinusitis was frequently missed on plain dental X-rays and CT scan reports. Dental pain and foul-smelling nasal discharge are present in less than one-half of patients and symptoms commonly persist for years. Otolaryngologists must have a high index of suspicion for an odontogenic cause of refractory maxillary sinusitis.
牙源性上颌窦炎（OMS）的发病率尚不清楚。如果未能解决导致鼻窦炎的牙科病变，可能会导致医疗和手术治疗的失败。本文旨在介绍一组 OMS 患者。
对前瞻性收集的患者进行回顾性分析。回顾鼻窦炎指南中 OMS 的发病率和治疗方法。评估了过去 30 个月中通过鼻窦计算机断层扫描（CT）扫描诊断的 21 例 OMS 患者的临床方面。
在我们的系列中，平均年龄为 53 岁（范围，21-70 岁），平均症状持续时间为 2.6 年（范围，1 个月至 15 年），21 例中有 10 例（48%）患者存在腐烂气味或异味，21 例中有 6 例（29%）患者存在牙痛，23 例中有 12 例（57%）患者存在单侧上颌窦混浊。7 例（86%）患者的 CT 扫描前牙科 X 光片和 21 例（67%）患者的初始鼻窦 CT 报告中均未发现牙科病变，但对 CT 扫描的重新评估发现所有患者均存在牙科病变。
在普通牙科 X 光片和 CT 扫描报告中，经常会遗漏导致鼻窦炎的牙科病变。不到一半的患者存在牙痛和恶臭的鼻腔分泌物，症状通常会持续数年。耳鼻喉科医生必须对难治性上颌窦炎的牙源性病因而保持高度怀疑。
