Melén I, Lindahl L, Andréasson L, Rundcrantz H
Acta Otolaryngol. 1986 Mar-Apr;101(3-4):320-7. doi: 10.3109/00016488609132845.
Various definitions have been proposed for the term 'chronic sinusitis' but too often reports on chronic sinusitis lack a definition. In order to improve the diagnosis and treatment of this disease, and also to facilitate comparisons between clinical investigations, definitions of 'chronic maxillary sinusitis' of either rhinogenous or dental origin are proposed. It is suggested that the differential diagnosis should be based upon the duration of symptoms, ENT and dental examinations, sinus radiographs and/or sinoscopy, and results of conservative treatment. In a study conducted over a 5-year period, 198 patients with 244 affected sinuses fulfilled the proposed criteria. The incidence of chronic maxillary sinusitis in the population was 0.02%. A dental cause was found in 40.6% of the sinuses. The dental cause could be confirmed by routine dental examination in only 43 of 99 cases, while an extended maxillo-dental examination was conclusive in the other cases (56/99). Marginal periodontitis was found as frequently as periapical granuloma and together they constituted 83% of all dental causes. Sinusitis of dental origin was rare before the age of 30. Every sixth patient was found to have nasal polyposis. When related to the number of affected sinuses, the incidence of nasal polyposis was 13.1% in sinusitis of dental origin and 23.4% in that of rhinogenous origin. The importance of close cooperation between the ENT specialist and the oral surgeon is stressed.
对于“慢性鼻窦炎”一词，人们提出了各种定义，但关于慢性鼻窦炎的报告往往缺乏定义。为了改善这种疾病的诊断和治疗，并便于临床研究之间的比较，本文提出了鼻源性或牙源性“慢性上颌窦炎”的定义。建议鉴别诊断应基于症状持续时间、耳鼻喉科和牙科检查、鼻窦X光片和/或鼻窦镜检查以及保守治疗结果。在一项为期5年的研究中，198例患者的244个患窦符合所提出的标准。该人群中慢性上颌窦炎的发病率为0.02%。40.6%的患窦发现有牙源性病因。在99例病例中，只有43例通过常规牙科检查能够确诊牙源性病因，而在其他病例（56/99）中，扩大的颌面牙科检查具有决定性意义。边缘性牙周炎与根尖肉芽肿的发现频率相同，它们共同构成了所有牙源性病因的83%。30岁之前牙源性鼻窦炎很少见。每六名患者中就有一名被发现患有鼻息肉。与患窦数量相关时，牙源性鼻窦炎中鼻息肉的发病率为13.1%，鼻源性鼻窦炎中为23.4%。强调了耳鼻喉科专家和口腔外科医生密切合作的重要性。
