Saibene Alberto Maria, Collurà Fabio, Pipolo Carlotta, Bulfamante Antonio Mario, Lozza Paolo, Maccari Alberto, Arnone Flavio, Ghelma Filippo, Allevi Fabiana, Biglioli Federico, Chiapasco Matteo, Portaleone Sara Maria, Scotti Alberto, Borloni Roberto, Felisati Giovanni
Otolaryngology Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Via A. di Rudinì, 8, 20142, Milan, Italy.
Disabled Advanced Medical Assistance Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy.
Eur Arch Otorhinolaryngol. 2019 Feb;276(2):401-406. doi: 10.1007/s00405-018-5220-0. Epub 2018 Nov 27.
Odontogenic sinusitis and sinonasal complications of dental disease or treatment (SCDDT) represent a heterogeneous group of conditions that often require multidisciplinary care. The present study aims to prospectively validate a classification and treatment protocol for SCDDT patients.
One hundred twenty-eight consecutive patients (73 females and 45 males, mean age 52.4 years) affected by SCDDT not responding to dental and medical therapy were classified and surgically treated according to the proposed protocol. The protocol classified patients into three aetiology-based groups (preimplantologic, implantologic, and related to traditional dental diseases and procedures, respectively). The groups were further divided into classes according to the presence of oro-antral communications and/or dislocated dental hardware. Each condition was treated according to the class-related, protocol-defined treatment, by either a transnasal or combined transnasal/transoral approach. All patients were successfully classified according to our protocol. None of the proposed classes were redundant, and no condition fell outside the definitions.
The surgical treatment protocol proved to be adequate and effective, in that 125 of the 128 patients completely recovered after surgical treatment.
The term SCDDT and the consequent classification proposed by the authors appear, therefore, to be nosologically correct. Furthermore, the protocol-related proposed treatment appears to be clinically sound, with a success rate nearing 98%.
牙源性鼻窦炎以及牙病或牙科治疗引发的鼻窦并发症（SCDDT）是一组异质性疾病，通常需要多学科治疗。本研究旨在前瞻性验证针对SCDDT患者的分类及治疗方案。
128例连续的SCDDT患者（73例女性，45例男性，平均年龄52.4岁），对牙科和药物治疗无反应，根据所提出的方案进行分类并接受手术治疗。该方案将患者分为三个基于病因的组（分别为种植前、种植相关以及与传统牙病和操作相关）。这些组再根据口鼻窦相通和/或牙用器械移位情况进一步分为不同类别。每种情况均根据与类别相关的、方案定义的治疗方法，采用经鼻或经鼻/经口联合入路进行治疗。所有患者均按照我们的方案成功分类。所提出的类别均无冗余，且没有情况超出定义范围。
手术治疗方案被证明是充分且有效的，因为128例患者中有125例在手术治疗后完全康复。
因此，作者提出的SCDDT这一术语及其相应分类在疾病分类学上似乎是正确的。此外，与方案相关的所提出的治疗方法在临床上似乎是合理的，成功率接近98%。
