Odontogenic rhinosinusitis and sinonasal complications of dental disease or treatment: prospective validation of a classification and treatment protocol

Eur Arch Otorhinolaryngol. 2019 Feb;276(2):401-406. doi: 10.1007/s00405-018-5220-0. Epub 2018 Nov 27.

Abstract

Purpose: Odontogenic sinusitis and sinonasal complications of dental disease or treatment (SCDDT) represent a heterogeneous group of conditions that often require multidisciplinary care. The present study aims to prospectively validate a classification and treatment protocol for SCDDT patients.

Methods: One hundred twenty-eight consecutive patients (73 females and 45 males, mean age 52.4 years) affected by SCDDT not responding to dental and medical therapy were classified and surgically treated according to the proposed protocol. The protocol classified patients into three aetiology-based groups (preimplantologic, implantologic, and related to traditional dental diseases and procedures, respectively). The groups were further divided into classes according to the presence of oro-antral communications and/or dislocated dental hardware. Each condition was treated according to the class-related, protocol-defined treatment, by either a transnasal or combined transnasal/transoral approach. All patients were successfully classified according to our protocol. None of the proposed classes were redundant, and no condition fell outside the definitions.

Results: The surgical treatment protocol proved to be adequate and effective, in that 125 of the 128 patients completely recovered after surgical treatment.

Conclusions: The term SCDDT and the consequent classification proposed by the authors appear, therefore, to be nosologically correct. Furthermore, the protocol-related proposed treatment appears to be clinically sound, with a success rate nearing 98%.

Keywords: Computed tomography; Dental implants; Endoscopic sinus surgery; Paranasal sinuses disease; Sinus lift; Sinusitis.

Publication types

  • Validation Study

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Clinical Protocols*
  • Dental Implants / adverse effects*
  • Endoscopy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Paranasal Sinuses / surgery
  • Prospective Studies
  • Rhinitis / etiology*
  • Rhinitis / therapy
  • Sinusitis / etiology*
  • Sinusitis / therapy
  • Stomatognathic Diseases / complications*

Substances

  • Anti-Bacterial Agents
  • Dental Implants