Recognizing odontogenic sinusitis: A national survey of otolaryngology chief residents

Am J Otolaryngol. 2020 Nov-Dec;41(6):102635. doi: 10.1016/j.amjoto.2020.102635. Epub 2020 Jul 4.

Abstract

Purpose: Odontogenic sinusitis is underrepresented in sinusitis literature as well as in the otolaryngology teaching curriculum sponsored by the American Academy of Otolaryngology-Head and Neck Surgery. Otolaryngologists and residents in training may therefore have a decreased awareness of the condition. The objective of this study was to survey otolaryngology chief residents toward the ends of their training to determine how often they considered odontogenic sinusitis as a cause of unilateral sinus disease.

Materials and methods: An online REDCap survey was conducted from December 2018 to January 2019. Online surveys were emailed to 119 Otolaryngology residency program directors in the United States of America, which were then forwarded to their chief residents. Surveys included 3 demographic and 4 clinical questions. Clinical questions included 3 computed tomography-based questions requiring either differential diagnoses or most likely diagnosis, and 1 question on residents' perceived prevalence of odontogenic sinusitis as a cause of unilateral sinus opacification. Answer choices were tabulated and compared based on geographic region and post-residency career plans.

Results: Of 293 chief residents emailed, 94 completed the survey (32.1%). While answer choices on imaging-based questions varied, odontogenic sinusitis was generally underrecognized. Approximately 70% of residents felt odontogenic sinusitis represented 0%-40% of unilateral sinus opacification. There were no statistically significant differences in answers based on geographic distribution or post-residency career plans.

Conclusions: Otolaryngology chief residents recognized odontogenic sinusitis with variable accuracy on imaging, and generally underestimated its prevalence as a cause of unilateral sinus opacification. Efforts should be made to teach otolaryngology residents about odontogenic sinusitis.

Keywords: Chronic rhinosinusitis; Endoscopic sinus surgery; Maxillary sinusitis; Odontogenic sinusitis; Unilateral sinus disease.

MeSH terms

  • Awareness*
  • Diagnosis, Differential
  • Humans
  • Internship and Residency*
  • Maxillary Sinusitis* / complications
  • Maxillary Sinusitis* / diagnosis
  • Maxillary Sinusitis* / diagnostic imaging
  • Online Systems
  • Otolaryngologists / psychology*
  • Otolaryngology / education*
  • Paranasal Sinus Diseases / etiology
  • Surveys and Questionnaires
  • Tomography, X-Ray Computed
  • United States