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牙病或牙科治疗鼻旁窦并发症管理的实际经验

Real-Life Experience in the Management of Sinonasal Complications of Dental Disease or Treatments.

作者信息

De Corso Eugenio, Rigante Mario, Mele Dario Antonio, Settimi Stefano, Penazzi Daniele, Lajolo Carlo, Cordaro Massimo, Panfili Marco, Montuori Claudio, Galli Jacopo, Paludetti Gaetano

机构信息

Unit of Otorhinolaryngology, Fondazione Policlinico Universitario A.Gemelli IRCCS, 00168 Rome, Italy.

Head and Neck and Sensory Organs Department, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.

出版信息

J Pers Med. 2022 Dec 16;12(12):2078. doi: 10.3390/jpm12122078.

Abstract

Diagnosis and management of sinonasal complications of dental diseases or treatment (SCDDT) may be challenging. We aimed to report our real-life experience in patients treated with endoscopic endonasal approach describing data about symptoms, etiology, extension of the disease and success rate. We evaluated retrospectively data about 262 patients diagnosed as SCDDT and managed from August 2015 to May 2022. In 44.65% cases, maxillary sinus complications were determined by a dental disorder; the remaining 55.34% of cases were iatrogenic. Patients were managed according to our multidisciplinary protocol including ENT, dental, and radiological evaluation. Treatments were planned with a personalized approach, based on the patient’s clinical characteristics; all patients were treated with an endonasal endoscopic mini-invasive conservative approach. Combined dental treatment was performed simultaneously in 152/262 (58%) of patients; in the remaining cases, it was postponed after surgery. The overall treatment success rate (symptom resolution and endoscopically observed maxillary sinus healing) was 96.5%. At 15 days after surgery, we observed a significant improvement in the quality of life. The mean post-operative Sinonasal outcome test-22 (SNOT-22) score was significantly lower compared to baseline (6 versus 43.4; p < 0.05). Our study showed that endoscopic sinus surgery can be a successful procedure for treatment of SCDDT, leading to fast resolution of sinonasal symptoms and improving the quality of life. Furthermore, the technique allows removal of migrated dental material or dental implants even in challenging cases.

摘要

牙病或牙病治疗引起的鼻窦并发症(SCDDT)的诊断和管理可能具有挑战性。我们旨在报告采用鼻内镜入路治疗患者的实际经验,描述有关症状、病因、疾病范围和成功率的数据。我们回顾性评估了2015年8月至2022年5月期间诊断为SCDDT并接受治疗的262例患者的数据。在44.65%的病例中,上颌窦并发症由牙病引起;其余55.34%的病例为医源性。患者根据我们的多学科方案进行管理,包括耳鼻喉科、牙科和放射学评估。根据患者的临床特征,采用个性化方法制定治疗计划;所有患者均采用鼻内镜微创保守方法治疗。152/262例(58%)患者同时进行了联合牙科治疗;其余病例在手术后推迟进行。总体治疗成功率(症状缓解和鼻内镜观察到的上颌窦愈合)为96.5%。术后15天时,我们观察到生活质量有显著改善。术后鼻窦结局测试-22(SNOT-22)平均得分显著低于基线(6比43.4;p<0.05)。我们的研究表明,鼻内镜鼻窦手术是治疗SCDDT的一种成功方法,可快速缓解鼻窦症状并改善生活质量。此外,即使在具有挑战性的病例中,该技术也能取出移位的牙科材料或牙种植体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d10/9781878/dd5d335aef34/jpm-12-02078-g001.jpg

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