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<p>Odontogenic sinusitis (OS) is a common disease in otolaryngology and oral and maxillofacial surgery; however, a treatment protocol has not been sufficiently established. The aim of this study is to propose a new treatment protocol for odontogenic sinusitis utilizing nasal approach apicoectomy.</p><p>Thirty-three patients diagnosed with odontogenic sinusitis were included. According to our protocol, extraction (EXT), root canal treatment (RCT), endoscopic sinus surgery (ESS), and ESS with apicoectomy by nasal approach were performed. Pretreatment infection status was evaluated by computed tomography (CT) scan using Lund-Mackay score.</p><p>Of the 33 enrolled patients, 11 patients with previously extracted causative teeth had ESS. Ten patients underwent EXT, and the success rate was 60.0% (6/10). The success rate of RCT was 0% (0/4). Apicoectomy was performed in 4 patients, 1 of whom underwent apicoectomy using endoscopic modified medial maxillectomy (EMMM) and 3 underwent inferior meatus antrostomy. The success rate of all ESS was 100% (24/24). By chi-square test, EXT had a higher success rate than RCT (<i>p</i> = 0.004). Comparing the combined RCT and EXT group with the ESS group, the success rate of ESS was higher (<i>p</i> = 0.001). All 12 patients who were not eligible for absolute tooth extraction were able to preserve their teeth (12/12).</p><p>In conclusions, all 33 patients with odontogenic sinusitis were cured by extraction or ESS with or without apicoectomy. Our surgical procedure has the advantage of preserving causative teeth.</p>

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A New Treatment Concept for Odontogenic Sinusitis

  • 期刊论文

  • 发表日期：

    2025年8月20日

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  • Tsutomu Nomura,
  • Yaeko Hara,
  • Hiroyasu Hayashi,
  • Yuka Kitano,
  • Shigeru Kikuchi

摘要

Odontogenic sinusitis (OS) is a common disease in otolaryngology and oral and maxillofacial surgery; however, a treatment protocol has not been sufficiently established. The aim of this study is to propose a new treatment protocol for odontogenic sinusitis utilizing nasal approach apicoectomy.

Thirty-three patients diagnosed with odontogenic sinusitis were included. According to our protocol, extraction (EXT), root canal treatment (RCT), endoscopic sinus surgery (ESS), and ESS with apicoectomy by nasal approach were performed. Pretreatment infection status was evaluated by computed tomography (CT) scan using Lund-Mackay score.

Of the 33 enrolled patients, 11 patients with previously extracted causative teeth had ESS. Ten patients underwent EXT, and the success rate was 60.0% (6/10). The success rate of RCT was 0% (0/4). Apicoectomy was performed in 4 patients, 1 of whom underwent apicoectomy using endoscopic modified medial maxillectomy (EMMM) and 3 underwent inferior meatus antrostomy. The success rate of all ESS was 100% (24/24). By chi-square test, EXT had a higher success rate than RCT (p = 0.004). Comparing the combined RCT and EXT group with the ESS group, the success rate of ESS was higher (p = 0.001). All 12 patients who were not eligible for absolute tooth extraction were able to preserve their teeth (12/12).

In conclusions, all 33 patients with odontogenic sinusitis were cured by extraction or ESS with or without apicoectomy. Our surgical procedure has the advantage of preserving causative teeth.