Acute rhinosinusitis - are we forgetting the possibility of a dental origin? A retrospective study of 385 patients

Abstract

Background: Odontogenic sinusitis (OS) is a common but underdiagnosed form of acute rhinosinusitis (ARS). OS carries no specific characteristics, but unilateral symptoms and certain microbiological as well as radiological findings indicate odontogenic origin. Aims/objectives: We studied the proportion of OS in ARS patients, the presence and associations of unilateral symptoms, and possible OS microbial and radiological findings. In addition, we investigated how this condition is recognised among ear, nose and throat specialists and radiologists. Materials and methods: All 676 ARS patients treated in the Department of Otorhinolaryngology at Helsinki University Hospital in 2013 were retrospectively enrolled. The data were collected from patients' hospital medical records, the laboratory database and radiological reports. Results: Odontogenic origin of ARS was suspected in 59 (15.3%) patients. Altogether (29.9%) 115 patients complained of unilateral symptoms and these were found to associate with probable oral microbial findings (p < .001). These findings covered 20.2% of isolates. Teeth were mentioned in 89.6% of the radiological reports. Conclusions and significance: OS is common among patients with ARS, and good diagnostic tools already exist in routine practice. Microbial and radiological findings should be carefully evaluated, especially in cases of unilateral symptoms.

Keywords: dental pulp diseases; diagnosis; iatrogenic disease; maxillary sinus; paranasal sinuses; periapical diseases; sinusitis.