Clinical and Radiological Analysis of Odontogenic Sinusitis: A Retrospective Study

TL;DR

This study examines the causes, symptoms, and treatment outcomes of odontogenic sinusitis, showing that combining sinus surgery with dental care leads to better results.

Contribution

The study highlights the importance of concurrent dental treatment with endoscopic sinus surgery for improved outcomes in odontogenic sinusitis.

Findings

Periodontal disease was the most common cause of odontogenic sinusitis.

Radiological imaging showed sinus involvement beyond the maxillary sinus in 78.4% of cases.

Patients receiving both ESS and dental treatment had significantly better outcomes (96.4% success rate).

Abstract

Background/Objectives: 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). Methods: 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. Results: 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 (p = 0.003). Conclusions: 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.

Figures