Yoo Shin Hyuk, Jung Hahn Jin, Park Soo Kyoung, Mo Ji-Hun
Department of Otorhinolaryngology, Dankook University College of Medicine, Cheonan 31151, Republic of Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju 28644, Republic of Korea.
J Clin Med. 2025 Apr 19;14(8):2821. doi: 10.3390/jcm14082821.
: Odontogenic sinusitis (ODS) is a distinct subtype of chronic rhinosinusitis that arises from dental pathology, with unique etiologies and treatment strategies. This study aimed to evaluate the clinical features, radiological findings, and surgical outcomes of ODS patients treated with endoscopic sinus surgery (ESS). : This retrospective study included 139 patients diagnosed with ODS who underwent ESS. Demographic characteristics, clinical symptoms, radiological findings, and treatment outcomes were analyzed. Outcomes were assessed using pre- and postoperative LundKennedy (L-K) scores, with additional evaluation of the impact of concurrent dental treatment. : The most common etiology was periodontal disease (60.4%), followed by dental implants (20.1%) and dental extractions (19.4%). Radiological findings revealed sinus involvement beyond the maxillary sinus in 78.4% of patients, with common abnormalities including periapical abscesses (60.4%), oroantral fistulas (19.4%), and implant-related complications (20.1%). Patients who received concurrent dental treatment with ESS demonstrated significantly better outcomes, with success rates of 96.4% compared to 73.9% for those without dental treatment ( 0.003). : ODS is frequently underdiagnosed due to overlapping symptoms with chronic rhinosinusitis of other origins. Radiological imaging is crucial for identifying dental pathologies contributing to ODS. Combining ESS with dental treatment significantly improves outcomes and is recommended as the optimal management strategy for ODS.
牙源性鼻窦炎(ODS)是慢性鼻-鼻窦炎的一种独特亚型,由牙齿病变引起,具有独特的病因和治疗策略。本研究旨在评估接受鼻内镜鼻窦手术(ESS)治疗的ODS患者的临床特征、影像学表现及手术效果。
本回顾性研究纳入了139例诊断为ODS并接受ESS的患者。分析了患者的人口统计学特征、临床症状、影像学表现及治疗效果。采用术前和术后的Lund-Kennedy(L-K)评分评估治疗效果,并额外评估同期牙科治疗的影响。
最常见的病因是牙周病(60.4%),其次是牙种植体(20.1%)和拔牙(19.4%)。影像学表现显示,78.4%的患者鼻窦受累超出上颌窦,常见异常包括根尖周脓肿(60.4%)、口腔上颌窦瘘(19.4%)和种植体相关并发症(20.1%)。接受ESS同期牙科治疗的患者治疗效果明显更好,成功率为96.4%,而未接受牙科治疗的患者成功率为73.9%(P = 0.003)。
由于与其他病因的慢性鼻-鼻窦炎症状重叠,ODS经常被漏诊。影像学检查对于识别导致ODS的牙齿病变至关重要。ESS与牙科治疗相结合可显著改善治疗效果,建议作为ODS的最佳治疗策略。