Tsuzuki K, Kuroda K, Hashimoto K, Okazaki K, Noguchi K, Kishimoto H, Nishikawa H, Sakagami M
Department of Otorhinolaryngology Head and Neck Surgery, Hyogo College of Medicine, Japan.
Department of Dentistry and Oral Surgery, Hyogo College of Medicine, Japan.
J Laryngol Otol. 2020 Mar;134(3):241-246. doi: 10.1017/S0022215120000535. Epub 2020 Mar 9.
This study aimed to propose appropriate management for odontogenic chronic rhinosinusitis.
Thirty-one adult patients with odontogenic chronic rhinosinusitis undergoing maxillary extraction were retrospectively analysed. Patients with (n = 21) and without (n = 10) oroantral fistula on computed tomography were classified. Functional endoscopic sinus surgery was performed when sinusitis did not improve after extraction. The critical indicators for surgical requirement in the management of odontogenic chronic rhinosinusitis were analysed.
Sinusitis significantly improved after extraction in both groups. Patients without oroantral fistula had significantly more severe remnant sinusitis than those with oroantral fistula after extraction on computed tomography (p = 0.0037). The requirement for functional endoscopic sinus surgery was statistically significant for patients without orofacial fistula over those with orofacial fistula (p < 0.0001). The surgical improvement ratio was 93 per cent.
The absence of oroantral fistula and severe sinusitis can be critical indicators for the requirement of functional endoscopic sinus surgery after extraction in the management of odontogenic chronic rhinosinusitis.
本研究旨在提出针对牙源性慢性鼻窦炎的恰当治疗方法。
对31例接受上颌骨拔除术的牙源性慢性鼻窦炎成年患者进行回顾性分析。根据计算机断层扫描结果，将有（n = 21）和无（n = 10）口腔上颌窦瘘的患者进行分类。若拔牙后鼻窦炎未改善，则进行功能性鼻内镜鼻窦手术。分析牙源性慢性鼻窦炎治疗中手术需求的关键指标。
两组患者拔牙后鼻窦炎均有显著改善。计算机断层扫描显示，拔牙后无口腔上颌窦瘘的患者残余鼻窦炎比有口腔上颌窦瘘的患者严重得多（p = 0.0037）。无口腔面部瘘的患者比有口腔面部瘘的患者进行功能性鼻内镜鼻窦手术的需求在统计学上有显著差异（p < 0.0001）。手术改善率为93%。
在牙源性慢性鼻窦炎的治疗中，无口腔上颌窦瘘和严重鼻窦炎可能是拔牙后进行功能性鼻内镜鼻窦手术需求的关键指标。
