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KMID : 0361020190620110624
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Korean Journal of Otolaryngology - Head and Neck Surgery
2019 Volume.62 No. 11 p.624 ~ p.630
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Analysis of Treatment Outcome Associated with Pre-Operative Diagnostic Accuracy Changes and Dental Treatment Timing in Odontogenic Sinusitis Involving Unilateral Maxillary Sinus
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Choi Ki-Yong
Mo Ji-Hun
Chung Young-Jun
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Abstract
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Background and Objectives: Unilateral sinusitis is caused by various factors. Odontogenicsinusitis; especially, is different from non-odontogenic sinusitis in clinical features and prognosis. The purpose of this study is to evaluate the prognosis of odontogenic sinusitis in accordancewith the changes in diagnostic accuracy over time and the timing of dental treatment.
Subjects and Method: 195 patients who underwent endoscopic sinus surgery for unilateralsinusitis within the interval from 2006 to 2017 were reviewed to analyze the etiologies andclinical characteristics. Preoperative CT was assessed to identify patients who had not been diagnosedwith odontogenic sinusitis in the past. In the unilateral bacterial sinusitis, we identifiedchanges in incidence, diagnostic accuracy, and outcome in the odontogenic sinusitis. Wedivided odontogenic sinusitis patients into three groups: preoperative and intraoperative dentaltreatment group, postoperative dental treatment group, and untreated group. Then we analyzedthe difference in prognosis of these three groups.
Results: The total number of patients with odontogenic sinusitis was 86 (44%), which accountedfor about 36% until 2011, but increased to about 48% after 2013. From 2006 to 2011,there were 15 cases of missed diagnosis of odontogenic sinusitis, but there was 1 case in 2012and no cases since 2013. The treatment outcome of unilateral bacterial sinusitis was significantlyincreased from 84.1% before 2011 to 96% after 2012. The success rate was 97.1% in thecase of accurate diagnosis of odontogenic sinusitis, but the success rate was 43.8% in case ofmissed diagnosis. In odontogenic sinusitis, the success rate was low when dental treatment wasnot performed. However, there was no difference in success rate among different dental treatmenttimings.
Conclusion: The incidence of odontogenic sinusitis has steadily increased over the last decade. The prognosis has been improved by appropriate treatment under accurate diagnosisthrough preoperative examination and radiological evaluation. There was no difference in theprognosis of odontogenic sinusitis according to the dental treatment time. Therefore, it is agood choice for tooth preservation to have an endoscopic sinus surgery first and then decidethe dental treatment timing
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KEYWORD
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Chronic rhinosinusitis, Odontogenic sinusitis, Treatment strategy
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