Preda Mihai Alexandru, Muşat Ovidiu, Sarafoleanu Caius Codruţ, Popescu Ioana Stella, Muşat Andreea, Pîrvulescu Ruxandra, Barac Ramona, Tătaru Călin Petru, Muşat Gabriela Cornelia
"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
"Sfanta Maria" Clinical Hospital, Bucharest, Romania.
Rom J Ophthalmol. 2023 Apr-Jun;67(2):175-179. doi: 10.22336/rjo.2023.30.
Odontogenic sinusitis is a well-known, but under-studied bacterial infection of the maxillary sinus that can extend to other sinuses, the orbit, or even the endocranium. We performed an observational retrospective study on the patients with odontogenic sinusitis treated in our hospital over a five-year period. We included patients over 18 years old diagnosed with odontogenic sinusitis and ocular complications and we excluded patients with ocular complications nonrelated to dental-originated sinusitis or patients with odontogenic sinusitis without orbital-ocular complications. We examined the charts of 46 patients. From the total number of patients with oculo-orbital complications generated by odontogenic sinusitis, only 7 were women. The mean age was 33,7 with a standard deviation of 15,7 years. The oculo-orbital complications were assessed according to the Chandler classification. The most frequent orbital complication was preseptal cellulitis followed by orbital cellulitis. All the patients were treated with antibiotic covering both anaerobic and aerobic bacteria and 40 of the patients in our study received surgical treatment. The outcomes were favorable for all the patients in our study with clinical resolution. The oculo-orbital complications of odontogenic sinusitis are severe because they can result in vision loss or other ocular sequelae. The bacteriological features of this sinusitis explain the special characteristics of this infection and can facilitate the extent of the infection to the orbit. Prompt intervention with antibiotics covering anaerobic and aerobic bacteria and surgery addressed to the affected sinus/ sinuses, the dental disease and the orbital pathology ensures a big success rate in the therapy of these complications.
牙源性鼻窦炎是一种众所周知但研究不足的上颌窦细菌感染，可蔓延至其他鼻窦、眼眶甚至颅内。我们对我院五年内治疗的牙源性鼻窦炎患者进行了一项观察性回顾性研究。我们纳入了18岁以上诊断为牙源性鼻窦炎并伴有眼部并发症的患者，排除了与牙源性鼻窦炎无关的眼部并发症患者或无眶-眼并发症的牙源性鼻窦炎患者。我们检查了46例患者的病历。在牙源性鼻窦炎引起的眶-眼并发症患者总数中，只有7名女性。平均年龄为33.7岁，标准差为15.7岁。根据钱德勒分类法评估眶-眼并发症。最常见的眼眶并发症是眶隔前蜂窝织炎，其次是眼眶蜂窝织炎。所有患者均接受了覆盖厌氧菌和好氧菌的抗生素治疗，我们研究中的40例患者接受了手术治疗。我们研究中的所有患者临床症状均得到缓解，预后良好。牙源性鼻窦炎的眶-眼并发症很严重，因为它们可能导致视力丧失或其他眼部后遗症。这种鼻窦炎的细菌学特征解释了这种感染的特殊性质，并可能促使感染蔓延至眼眶。及时使用覆盖厌氧菌和好氧菌的抗生素进行干预，并对受影响的鼻窦、牙齿疾病和眼眶病变进行手术治疗，可确保这些并发症的治疗成功率很高。
