Otolaryngologists' perceptions of odontogenic maxillary sinusitis.

OBJECTIVES/HYPOTHESIS: Odontogenic maxillary sinusitis (OMS) is a common cause of chronic rhinosinusitis (CRS); however, the condition is infrequently mentioned in recent rhinosinusitis guidelines and often overlooked as a cause of sinusitis by otolaryngologists, dentists, and radiologists. The goal of this survey is to assess otolaryngologists' perceptions of the incidence, diagnosis, and treatment of OMS.

STUDY DESIGN

Physician survey.

METHODS

Ninety-three board certified otolaryngologists in the United States completed a 17-question survey on etiologies of CRS, which also included questions on alternative diagnoses and radiologic findings to reduce respondent bias toward the survey's focus on odontogenic sinusitis. Results were compared between self-reported general otolaryngologists and rhinologists.

RESULTS

Both groups recognized an odontogenic source as a common cause of maxillary sinusitis and reported treating an average of 2.9 patients per year with OMS who were initially misdiagnosed. Most otolaryngologists surveyed perceived radiologists to never or rarely report on dental pathology in their sinus computed tomography (CT) interpretation.

CONCLUSIONS

Both general otolaryngologists and rhinologists recognize odontogenic sinusitis is common, although often initially misdiagnosed. With increasing awareness of OMS, we believe that otolaryngologists and radiologists will review sinus CT scans for the presence of periapical abscesses and dental pathology. The otolaryngologist should suspect an odontogenic etiology of purulent maxillary CRS in patients failing to improve with antibiotics, regardless of a negative dental workup.