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. 2020 Nov 2;20(4):524-530.
doi: 10.17305/bjbms.2020.4748.

Chronic maxillary sinusitis of dental origin and oroantral fistula: The results of combined surgical approach in an Italian university hospital

Massimo Galli  1 , Giulia De Soccio  2 , Fabrizio Cialente  2 , Francesca Candelori  2 , Francesca Romana Federici  1 , Massimo Ralli  2 , Marco De Vincentiis  1 , Antonio Minni  2
Affiliations

Chronic maxillary sinusitis of dental origin and oroantral fistula: The results of combined surgical approach in an Italian university hospital

Massimo Galli et al. Bosn J Basic Med Sci. .

Abstract

Unilateral chronic maxillary sinusitis is a possible complication of odontogenic disease or dental treatment and is mainly due to the development of an oroantral fistula (OAF). The management of chronic maxillary sinusitis of dental origin (CMSDO) requires a combined treatment via endoscopic sinus surgery (ESS) and intraoral surgical treatment of the odontogenic source. The aim of this study is to present the results of our university hospital unit in the treatment and follow-up of a case series of 34 patients treated with a combined surgical approach for CMSDO due to OAF. All patients were treated with ESS combined with an intraoral approach. No intraoperative or immediate postoperative complications were observed; nasal synechia was found in 3 patients (8.82%). The overall success rate after the primary intervention was 94.12%; recurrence was observed in 2 cases (5.88%), both were suffering from diabetes mellitus and were tobacco smokers. Our results confirm that simultaneous surgery with a combination of an intraoral and endoscopic approach can be considered the best strategy for the long-term restoration of normal sinonasal homeostasis in selected patients with chronic odontogenic sinusitis and OAF, guaranteeing an effective treatment with minimal complications in the short and long term.

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Conflict of interest statement

Conflict of interest statement: The authors declare no conflict of interests

Figures

FIGURE 1
FIGURE 1
Upper panel: computed tomography scan in the axial (A), coronal (B), and sagittal (C) planes of a patient with right maxillary sinusitis and a large oroantral fistula. Lower panel: computed tomography scan in the axial (D), coronal (E), and sagittal (F) planes of a patient with a wide floor defect of the left maxillary sinus associated with implant displacement and complete sinus obliteration.
FIGURE 2
FIGURE 2
(A) Intraoral surgical approach. A large bony defect was found after the extraction of two molars. (B) The Rehrmann flap was closed with a free-tension flap and eversion to avoid wound dehiscence.
FIGURE 3
FIGURE 3
Two months after surgery, complete wound healing was observed.
See this image and copyright information in PMC

References

    1. Mavrodi A, Paraskevas G. Evolution of the paranasal sinuses'anatomy through the ages. Anat Cell Biol. 2013;46(4):235–8. https://doi.org/10.5115/acb.2013.46.4.235. - PMC - PubMed
    1. Newsome HA, Poetker DM. Odontogenic sinusitis:Current concepts in diagnosis and treatment. Immunol Allergy Clin North Am. 2020;40(2):361–9. https://doi.org/10.1016/j.iac.2019.12.012. - PubMed
    1. Little RE, Long CM, Loehrl TA, Poetker DM. Odontogenic sinusitis:A review of the current literature. Laryngoscope Investig Otolaryngol. 2018;3(2):110–4. https://doi.org/10.1002/lio2.147. - PMC - PubMed
    1. Simuntis R, Kubilius R, Vaitkus S. Odontogenic maxillary sinusitis:A review. Stomatologija. 2014;16(2):39–43. - PubMed
    1. Dym H, Wolf JC. Oroantral communication. Oral Maxillofac Surg Clin North Am. 2012;24(2):239–47. 8-9. https://doi.org/10.1016/j.coms.2012.01.015. - PubMed

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