Odontogenic sinusitis (ODS) is more common than previously reported and is underrepresented in the sinusitis literature. Next, Dr. Zheng Ligang will talk about this problem based on his own experience and literature.
Odontogenic sinusitis differs from rhinosinusitis in that it is a complication of infectious sinusitis or dental surgery caused by an infectious dental source and is most commonly unilateral.
The clinical features, microbiology, diagnosis, and treatment patterns of odontogenic sinusitis also differ from those of sinusitis. Evaluation and management of odontogenic sinusitis should usually be performed by an otolaryngologist and dentist, and the clinician must be able to suspect and confirm the condition. The suspicion of odontogenic sinusitis is caused by certain clinical features, such as computed tomography showing unilateral maxillary sinus opacity, computed tomography showing obvious maxillary tooth pathology, nasal endoscopy showing unilateral purulent discharge from the middle meatus, foul odor, and odontogenic bacteria in sinus cultures.
An otolaryngologist should confirm sinusitis by nasal endoscopy and evaluate for midnasal passage discharge, edema, or polyps. The dentist should confirm the dental pathology with proper examination and imaging. Once odontogenic sinusitis has been identified, a multidisciplinary shared decision-making process should be undertaken to discuss the timing and risks and benefits of different types of dental and sinus surgical interventions.
Oral antibiotics are usually ineffective in resolving odontogenic sinusitis, especially if there is a treatable tooth lesion. When both dental pathology and sinusitis are resolved, 90%-100% of cases can be expected to be resolved. For treatable dental lesions, while primary dental treatment may resolve sinusitis, a large percentage of patients require endoscopic sinus surgery. For patients with severe sinusitis symptoms, primary endoscopic sinus surgery is an option for faster resolution of symptoms, followed by appropriate dental treatment. More well-designed research is needed in all areas of ozone-depleting substances.
If you still have any questions about odontogenic sinusitis, please leave a message and communicate with Dr. Zheng Ligang for further communication.