Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Department of Otorhinolaryngology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Clin Oral Investig. 2021 Mar;25(3):947-955. doi: 10.1007/s00784-020-03384-4. Epub 2020 Jun 4.
Chronic rhinosinusitis (CRS) frequently stems from a dental origin, although odontogenic sinusitis (OS) remains underdiagnosed amongst different professionals. This study aimed to explore how often odontogenic causes are considered when diagnosing CRS.
Patient records from 374 new CRS patients treated at a tertiary-level ear, nose, and throat (ENT) clinic were selected. Entries and radiological reports were assessed exploring how often dentition was mentioned and OS was suspected, how often radiologists reported maxillary teeth, and how commonly typical OS microbial findings and unilateral symptoms occurred.
Although 10.1% of the CRS diagnoses were connected to possible dental issues, teeth were not mentioned for 73.8% of patients. Radiological reports were available from 267 computed or cone beam computed tomographies, of which 25.1% did not mention the maxillary teeth. The reported maxillary teeth pathology was not considered in 31/64 (48.4%) cases. Unilateral symptoms associated with apical periodontitis (OR = 2.49, 95% CI 1.27-4.89, p = 0.008). Microbial samples were available from 88 patients, for whom Staphylococcus aureus was the most common finding (17% of samples).
Odontogenic causes are often overlooked when diagnosing CRS. To provide adequate treatment, routine assessment of patient's dental history and status, careful radiograph evaluation, and utilization of microbial findings should be performed. Close cooperation with dentists is mandatory.
Dental professionals should be aware of difficulties medical professionals encounter when diagnosing possible OS. Thus, sufficient knowledge of OS pathology is essential to both medical and dental professionals.
慢性鼻-鼻窦炎（CRS）常源于牙源性，但不同专业的医生对牙源性鼻窦炎（OS）的诊断仍不足。本研究旨在探讨在诊断 CRS 时，牙源性病因被考虑的频率。
选择在三级耳鼻喉科（ENT）诊所治疗的 374 例新 CRS 患者的病历。评估病历和放射报告，以了解齿列是否经常被提及以及 OS 是否被怀疑，放射科医生报告上颌牙齿的频率，以及典型 OS 微生物发现和单侧症状的常见频率。
尽管 10.1%的 CRS 诊断与可能的牙齿问题有关，但有 73.8%的患者未提及牙齿。267 例计算机断层扫描或锥形束计算机断层扫描中有 25.1%未提及上颌牙齿。在 31/64（48.4%）病例中，未考虑报告的上颌牙齿病理学。与根尖周炎相关的单侧症状（OR=2.49，95%CI 1.27-4.89，p=0.008）。从 88 名患者中获得了微生物样本，其中金黄色葡萄球菌是最常见的发现（17%的样本）。
在诊断 CRS 时，牙源性病因经常被忽视。为了提供适当的治疗，应常规评估患者的牙科病史和状况，仔细进行放射学评估，并利用微生物发现，必须与牙医密切合作。
牙科医生应该意识到医疗专业人员在诊断可能的 OS 时遇到的困难。因此，医学和牙科专业人员都需要充分了解 OS 病理学。
