Safadi Ahmad, Kleinman Shlomi, Oz Itay, Wengier Anat, Mahameed Fadi, Vainer Igor, Ungar Omer J
Senior, Department of Otolaryngology - Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Senior, Department of Otolaryngology - Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
J Oral Maxillofac Surg. 2020 May;78(5):762-770. doi: 10.1016/j.joms.2019.12.025. Epub 2020 Jan 7.
Odontogenic sinusitis (OS) can be caused by infectious conditions of the posterior maxillary teeth. The maxillary sinus has been most often involved because of its proximity to the posterior maxillary teeth. Often the anterior ethmoids and frontal sinuses will be involved by the infective process. The underlying odontogenic condition must be addressed before or during sinus surgery. The role of frontal sinusotomy in the treatment of these patients has been poorly described. Our objective was to present the surgical outcomes of patients with OS involving the frontal sinus who had undergone middle meatal antrostomy alone.
A prospective analysis of all patients who had undergone surgery at a single tertiary center to treat OS involving the frontal sinus from November 2015 to December 2018 was performed. Their preoperative assessment findings, surgical findings, and postoperative outcomes were analyzed.
A total of 45 patients (23 men and 22 women), with a median age of 57 years (range, 20 to 83 years), were enrolled in the present study. All anterior sinuses (frontal, anterior ethmoids, and maxillary sinuses) were clinically and radiographically involved in all the patients. Each patient underwent endoscopic wide maxillary middle meatal antrostomy concurrent with dental intervention. The average follow-up was 7 months. No signs of active frontal disease were detected by postoperative endoscopy in any patient, and no patient required revision surgery.
The results from the present study have shown that no justification exists for frontal sinusotomy for the treatment of OS involving the frontal sinus. Frontal sinusitis is a secondary infectious and inflammatory process that will resolve once the underlying odontogenic condition has healed and wide middle meatal antrostomy has been performed.
牙源性鼻窦炎（OS）可由上颌后牙的感染性疾病引起。上颌窦因靠近上颌后牙而最常受累。通常，前筛窦和额窦也会被感染过程累及。在鼻窦手术前或手术期间必须处理潜在的牙源性疾病。额窦切开术在这些患者治疗中的作用描述甚少。我们的目的是介绍仅接受中鼻道上颌窦造口术的额窦受累OS患者的手术结果。
对2015年11月至2018年12月在单一三级中心接受手术治疗额窦受累OS的所有患者进行前瞻性分析。分析他们的术前评估结果、手术结果和术后结果。
本研究共纳入45例患者（23例男性和22例女性），中位年龄57岁（范围20至83岁）。所有患者的前组鼻窦（额窦、前筛窦和上颌窦）在临床和影像学上均受累。每位患者在进行牙科干预的同时接受了内镜下广泛的上颌中鼻道上颌窦造口术。平均随访7个月。术后内镜检查未在任何患者中发现额窦有活动性疾病迹象，也没有患者需要再次手术。
本研究结果表明，对于治疗额窦受累的OS，没有理由进行额窦切开术。额窦炎是一种继发性感染和炎症过程，一旦潜在的牙源性疾病愈合且进行了广泛的中鼻道上颌窦造口术，它就会消退。
