Matsumoto Yuma, Yokoi Hidenori, Ikeda Tetsuya, Kawada Michitsugu, Saito Koichiro
Department of Otolaryngology-Head and Neck Surgery, Kyorin University School of Medicine, Tokyo, Japan.
Department of Oral Surgery, Kyorin University School of Medicine, Tokyo, Japan.
Allergy Rhinol (Providence). 2021 Jan 29;12. doi: 10.1177/2152656721989287. eCollection 2021 Jan-Dec.
We investigated cases with opacification on maxillary sinus computed tomography (CT) among patients with rhinosinusitis with opacification in both paranasal sinuses (bilateral rhinosinusitis) to confirm the involvement of odontogenic infections.
This study included 75 patients who were diagnosed with bilateral rhinosinusitis based on clinical examination and evident opacification on at least one side on maxillary sinus imaging with computed tomography CT. The definition of odontogenic sinusitis was determined by examining EPT and oral findings, in addition to the CT and orthopantomography (OP), by one oral surgeon and two otolaryngologists.
We found that 45.3% of patients had odontogenic infections, which were associated with multiple infected teeth in some cases. Odontogenic infection was observed in both sinuses in some patients. Sinusitis with polyps was frequently associated with dental infection, and some cases were also associated with mycosis. Almost no oral symptoms were observed.
The results suggest that clinicians should consider odontogenic infection in patients with bilateral rhinosinusitis with opacification, on at least one side on maxillary sinus imaging. This means that accurate diagnosis may be challenging for otolaryngologist or dentists alone, suggesting that a collaboration between the two would be suitable for this task.
我们对双侧鼻窦浑浊（双侧鼻窦炎）且上颌窦计算机断层扫描（CT）显示浑浊的鼻窦炎患者进行了调查，以确认牙源性感染的影响。
本研究纳入了75例患者，这些患者经临床检查确诊为双侧鼻窦炎，且上颌窦计算机断层扫描（CT）成像至少一侧有明显浑浊。除了CT和曲面断层摄影（OP）外，由一名口腔外科医生和两名耳鼻喉科医生通过检查牙髓活力测试（EPT）和口腔检查结果来确定牙源性鼻窦炎的定义。
我们发现45.3%的患者存在牙源性感染，在某些情况下与多颗感染牙齿有关。在一些患者的双侧鼻窦中均观察到牙源性感染。伴有息肉的鼻窦炎常与牙齿感染有关，部分病例还与真菌病有关。几乎未观察到口腔症状。
结果表明，临床医生应考虑上颌窦成像至少一侧有浑浊的双侧鼻窦炎患者存在牙源性感染。这意味着仅靠耳鼻喉科医生或牙医进行准确诊断可能具有挑战性，提示两者合作适合这项任务。
