Troeltzsch Matthias, Pache Christoph, Troeltzsch Markus, Kaeppler Gabriele, Ehrenfeld Michael, Otto Sven, Probst Florian
Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University of Munich, Munich, Germany.
Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University of Munich, Munich, Germany.
J Craniomaxillofac Surg. 2015 Oct;43(8):1522-9. doi: 10.1016/j.jcms.2015.07.021. Epub 2015 Jul 29.
The purpose of the study was to analyze the causative pathology associated with symptomatic unilateral maxillary sinusitis requiring surgical treatment. A retrospective review of all patients that have been treated surgically for unilateral symptomatic maxillary sinusitis between 2006 and 2013 at a single institution was performed. Demographic, anamnesis, clinical, radiological, microbiological and histological data were gathered and analyzed. The patients were allocated into groups depending on the underlying cause of the disease. Descriptive and inferential statistics were computed (level of significance: p ≤ 0.05). The study sample was composed of 174 patients (72 female; 102 male) with a mean age of 52.7 years (SD 16.9). Most cases (130; 75%) were triggered by odontogenic pathology following dentoalveolar surgical interventions (83/130 patients; 64%). Other etiological factors for odontogenic unilateral sinusitis were periapical (23/130 cases; 18%) and periodontal pathology (13/130 cases; 10%). Rhinogenic factors for sinusitis were detected in 13 patients (7.5%) and dental implant-associated unilateral maxillary sinusitis was diagnosed in nine patients (5.2%). Four patients (2.3%) had undergone previous sinus augmentation surgery. A leading cause for the sinus infection could not be identified in 18 patients (10%) who all had a history of midfacial surgery. Medication-related osteonecrosis of the jaw (8) and squamous cell carcinoma (2) were incidental findings. There were no differences in the clinical appearance of the disease with respect to its etiology. Odontogenic causes for maxillary sinusitis must be considered especially in unilateral cases. Maxillary dental implants may induce symptomatic unilateral maxillary sinusitis.
本研究的目的是分析与需要手术治疗的症状性单侧上颌窦炎相关的致病病理。对2006年至2013年在单一机构接受手术治疗的所有单侧症状性上颌窦炎患者进行了回顾性研究。收集并分析了人口统计学、病史、临床、放射学、微生物学和组织学数据。根据疾病的潜在病因将患者分组。计算描述性和推断性统计数据（显著性水平：p≤0.05）。研究样本包括174例患者（女性72例；男性102例），平均年龄52.7岁（标准差16.9）。大多数病例（130例；75%）是由牙槽外科手术后的牙源性病理引发的（83/130例患者；64%）。牙源性单侧鼻窦炎的其他病因是根尖周病变（23/130例；18%）和牙周病变（13/130例；10%）。在13例患者（7.5%）中检测到鼻窦炎的鼻源性因素，9例患者（5.2%）被诊断为与牙种植体相关的单侧上颌窦炎。4例患者（2.3%）曾接受过鼻窦增高手术。18例有面中部手术史的患者（10%）无法确定鼻窦感染的主要原因。颌骨药物性骨坏死（8例）和鳞状细胞癌（2例）为偶然发现。就病因而言，该疾病的临床表现没有差异。尤其是在单侧病例中，必须考虑上颌窦炎的牙源性病因。上颌牙种植体可能诱发症状性单侧上颌窦炎。
