Maxillofacial Surgery Unit, Azienda Ospedaliero Universitaria of Udine, Udine, Italy.
Department of Otorhinolaryngology and Otologic Surgery, Azienda Ospedaliera, Policlinico of Padova, Padova, Italy.
J Craniomaxillofac Surg. 2019 Aug;47(8):1249-1254. doi: 10.1016/j.jcms.2019.04.012. Epub 2019 May 4.
The aim of this study was to review clinical and radiological presentation, surgery, and results of treatment in patients with chronic odontogenic maxillary sinusitis (OMS) treated with a single surgical procedure, including endoscopic sinus surgery (ESS) and oral surgical approaches to treat the odontogenic source of infection.
A retrospective case series analysis of 98 patients was performed. All the patients received ESS. 88 patients required oral surgical approaches.
Nasal symptoms were present in 58 patients (59.2%). Nasal endoscopy was positive in 65 patients (66.3%). A positive nasal endoscopy was significantly associated with nasal symptoms (p < 0.05). 60 patients (61.2%) had OMS of iatrogenic origin. Total opacification of the maxillary sinus was the most common radiological presentation (74.5%) and was significantly associated with nasal symptoms (p < 0.05). 91 patients (92.9%) had complete clinical and radiological resolution of the OMS.
Iatrogenic origin, sinonasal symptoms and positive clinical endoscopy are common in patients with OMS. Nasal symptoms were significantly associated with total maxillary sinus opacification and positive endoscopic clinical examination. Combining treatment of the odontogenic source of infection via an oral surgical approach and of the sinus inflammation by ESS appears to be sufficient for successfully treating patients with OMS.
本研究旨在回顾慢性牙源性上颌窦炎（OMS）患者的临床和放射学表现、手术及治疗结果，这些患者采用单一手术治疗，包括内镜鼻窦手术（ESS）和口腔外科方法来治疗感染的牙源性来源。
对 98 例患者进行回顾性病例系列分析。所有患者均接受 ESS 治疗。88 例患者需要口腔外科方法。
58 例（59.2%）患者存在鼻部症状。65 例（66.3%）患者的鼻腔内镜检查阳性。阳性鼻腔内镜检查与鼻部症状显著相关（p<0.05）。60 例（61.2%）患者为医源性 OMS。上颌窦完全不透光是最常见的影像学表现（74.5%），与鼻部症状显著相关（p<0.05）。91 例（92.9%）患者的 OMS 临床和影像学完全缓解。
医源性、鼻-鼻窦症状和阳性临床内镜检查在 OMS 患者中较为常见。鼻部症状与上颌窦完全不透光和阳性内镜临床检查显著相关。通过口腔外科方法治疗感染的牙源性来源，并通过 ESS 治疗窦炎，似乎足以成功治疗 OMS 患者。
