Gâta Anda, Toader Corneliu, Valean Dan, Trombitaș Veronica Elena, Albu Silviu
Department of Otorhinolaryngology, University of Medicine and Pharmacy 'Iuliu Hațieganu', 400349 Cluj Napoca, Romania.
Clinic of Neurosurgery, National Institute of Neurology and Neurovascular Diseases, 41914 Bucharest, Romania.
J Clin Med. 2021 Jun 19;10(12):2712. doi: 10.3390/jcm10122712.
Odontogenic sinusitis (ODS) is frequently encountered in ENT practice; however, there are no guidelines regarding its management. This study aims to analyse the results of endoscopic sinus surgery versus dental treatment in ODS. Additionally, we aim to demonstrate the benefit of associating endoscopic sinus surgery (ESS) to surgical closure of chronic oroantral fistulas (OAF) by comparing mean time to healing in patients who opted or not for concurrent ESS.
Records of patients with ODS were reviewed. Group one consisted of patients with ODS caused by periapical pathology undergoing either endoscopic sinus surgery (ESS) or dental treatment. Resolution of ODS was considered treatment success and was compared between the two treatment strategies. Group two included patients with ODS and associated chronic oroantral communication. Time to healing was compared between patients undergoing OAF closure alone versus patients receiving associated ESS, using the Log-Rank test to correlate Kaplan-Meier curves.
25 patients from a total of 45 in group one underwent dental treatment alone, and 20 opted for exclusive ESS treatment. The failure rate was 40% for patients treated with ESS compared to 4% (one patient) for dental treatment. ODS resolved in all patients in the second group, but the mean time to healing was half (10 days) when ESS was complementary to OAF closure.
The present study represents the first estimator of the role ESS plays in OAF treatment. Nonetheless, it provides proof of the importance of first addressing dental problems in odontogenic sinusitis.
牙源性鼻窦炎（ODS）在耳鼻喉科临床实践中较为常见；然而，目前尚无关于其治疗的指南。本研究旨在分析内镜鼻窦手术与牙源性鼻窦炎牙科治疗的效果。此外，我们旨在通过比较选择或未选择同期内镜鼻窦手术（ESS）的患者的平均愈合时间，来证明将内镜鼻窦手术（ESS）与慢性口腔上颌窦瘘（OAF）手术闭合相结合的益处。
回顾牙源性鼻窦炎患者的病历。第一组由因根尖周病变引起牙源性鼻窦炎且接受内镜鼻窦手术（ESS）或牙科治疗的患者组成。ODS的缓解被视为治疗成功，并对两种治疗策略的效果进行比较。第二组包括患有牙源性鼻窦炎并伴有慢性口腔上颌窦交通的患者。采用对数秩检验来关联Kaplan-Meier曲线，比较单纯进行OAF闭合的患者与接受同期ESS的患者的愈合时间。
第一组共45例患者，其中25例仅接受牙科治疗，20例选择单纯ESS治疗。接受ESS治疗的患者失败率为40%，而牙科治疗的失败率为4%（1例患者）。第二组所有患者的ODS均得到缓解，但当ESS辅助OAF闭合时，平均愈合时间减半（10天）。
本研究首次评估了ESS在OAF治疗中的作用。尽管如此，它证明了在牙源性鼻窦炎中首先解决牙齿问题的重要性。
