Lambrecht J T
Abteilung für Zahnärztliche Chirurgie, -Radiologie und Stomatologie, Zahnärztliches Institut, Universität Basel, Schweiz.
Fortschr Kiefer Gesichtschir. 1995;40:106-13.
Odontogenic maxillary sinusitis is aetiologically different from rhinogenic maxillary sinusitis. Accordingly, there are distinct and--for the oral maxillofacial surgeon--very specific therapeutic consequences. The general clinical diagnostical principles have scarcely changed in the last years. In diagnostic imaging, computed tomography and magnetic resonance tomography are of great importance, especially concerning pre-operative diagnostics. Endoscopical techniques have been enhanced with the introduction of microcamera-supported endoscopy, a technical improvement. Therapeutical principles are: complete treatment of odontogenic factors in the whole quadrant; conservative and operative therapeutical procedures are to be combined. Other than in the ENT field, where the maxillary sinus is approached by an endo-nasal technique--infundibulotomy-in oral and maxillofacial surgery the transalveolar approach through the fossa canina is used when treating odontogenic maxillary sinusitis. However, cautious methods assuring the preservation of tissue in all respects are treatment of choice.
牙源性上颌窦炎在病因上与鼻源性上颌窦炎不同。因此，对于口腔颌面外科医生而言，存在明显且非常特殊的治疗后果。过去几年，一般临床诊断原则几乎没有变化。在诊断成像方面，计算机断层扫描和磁共振断层扫描非常重要，尤其是在术前诊断方面。随着微摄像头辅助内窥镜的引入，内窥镜技术得到了改进，这是一项技术进步。治疗原则是：对整个象限的牙源性因素进行全面治疗；保守治疗和手术治疗方法应相结合。与耳鼻喉科领域通过鼻内技术（即漏斗切开术）处理上颌窦不同，在口腔颌面外科治疗牙源性上颌窦炎时，采用经牙槽途径通过犬齿窝进行治疗。然而，在各方面确保组织保存的谨慎方法是首选治疗方法。
