Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan.
Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan.
Int J Environ Res Public Health. 2022 Jun 17;19(12):7430. doi: 10.3390/ijerph19127430.
Although maxillary sinusitis often occurs in patients with medication-related osteonecrosis of the jaw (MRONJ) of the upper jaw, there have been few reports on the treatment and outcomes for maxillary sinusitis associated with maxillary MRONJ. This study aimed to retrospectively investigate the treatment outcomes of maxillary sinusitis in patients with MRONJ of the upper jaw. There were 34 patients diagnosed with maxillary MRONJ and sinusitis by preoperative computed tomography who underwent surgery in our institution between January 2011 and December 2019. Age, sex, primary disease, stage of MRONJ, class and administration period of an antiresorptive agent, corticosteroid administration, preoperative leukocyte count and serum albumin level, periosteal reaction, sinusitis grade, maxillary sinus surgical procedure, and treatment outcomes of MRONJ and sinusitis were examined. There were 7 male and 27 female patients (average age, 74.7 years). Complete healing of MRONJ was obtained in 29 of 34 patients (85.3%). Maxillary sinusitis resolved or improved in 21 patients (61.8%) but did not change or worsen in 13 patients (38.2%). We found that complete resection of necrotic bone with intraoperative irrigation of the maxillary sinus may provide good treatment outcomes for maxillary sinusitis associated with MRONJ, although our findings were not statistically significant owing to the small number of patients.
尽管上颌窦炎常发生于接受药物相关性颌骨骨髓炎(MRONJ)治疗的上颌骨患者中,但有关上颌 MRONJ 相关上颌窦炎的治疗和结局的报道较少。本研究旨在回顾性调查上颌 MRONJ 患者上颌窦炎的治疗结局。2011 年 1 月至 2019 年 12 月,我们机构对术前 CT 诊断为上颌 MRONJ 和窦炎的 34 例患者进行了手术治疗。检查了年龄、性别、基础疾病、MRONJ 分期、抗吸收剂的类别和管理时间、皮质类固醇的使用、术前白细胞计数和血清白蛋白水平、骨膜反应、窦炎分级、上颌窦手术程序以及 MRONJ 和窦炎的治疗结局。患者中,男性 7 例,女性 27 例(平均年龄 74.7 岁)。34 例患者中有 29 例(85.3%)MRONJ 完全愈合。21 例(61.8%)上颌窦炎缓解或改善,13 例(38.2%)无变化或恶化。我们发现,术中对上颌窦进行彻底清创和灌洗可能为 MRONJ 相关上颌窦炎提供良好的治疗结局,但由于患者数量较少,我们的发现无统计学意义。