2018 Volume 61 Issue 4 Pages 202-208
No standard treatment has been established yet for odontogenic maxillary sinusitis (OMS), including in terms of dental treatment and/or endoscopic sinus surgery (ESS). To determine whether the findings on pretreatment computed tomographic imaging (CT) and demographic factors may be correlated with the therapeutic outcomes, we reviewed the treatment methods (dental treatment, ESS, and long-term macrolide therapy) and rates of improvement in patients with OMS. From October 2012 to May 2014, 107 subjects were enrolled in this study.
ESS (alone or with another treatment) was performed in 52 patients (48.6%), ESS plus dental treatment in 25 patients (23.4%), dental treatment alone in 20 patients (18.7%), and long-term macrolide therapy was administered in 32 patients (29.9%). Patients who received both ESS and dental treatment were significantly more likely to show improvement (76.0%, p=0.017) as compared to patients who received macrolide therapy alone (28.1%, p=0.000). Patients who received macrolide therapy alone were significantly less likely to show improvement if they had nasal deviation (p=0.021), obstruction of the ostiomeatal complex on the affected side (p=0.012), shadows on the CT images extending to the ethmoid sinus (p=0.022), and/or shadows on the CT images extending to the frontal sinus (p=0.026).
Our results suggest that patients with OMS are unlikely to be cured by dental treatment alone, with the outcomes depending on the distributions of the paranasal sinus shadows on CT imaging and the nasal findings. These results indicate that otolaryngologists and dentists should collaborate to develop the most appropriate treatment for patients with OMS.
