4.1 Article

Odontogenic chronic rhinosinusitis patients undergoing tooth extraction: oral surgeon and otolaryngologist viewpoints and appropriate management

Journal

JOURNAL OF LARYNGOLOGY AND OTOLOGY
Volume 134, Issue 3, Pages 241-246

Publisher

CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0022215120000535

Keywords

Radicular Cyst; Maxillary Sinusitis; Paranasal Sinuses; Tooth Extraction; Nasal Surgical Procedures

Funding

  1. (KAKENHI) from the Japan Society for the Promotion of Science [JP25462671, JP16K11220]
  2. Hyogo College of Medicine
  3. Practical Research Project for Rare/Intractable Diseases from the Japan Agency for Medical Research and Development [JP 16ek0109062]

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Objective This study aimed to propose appropriate management for odontogenic chronic rhinosinusitis. Method Thirty-one adult patients with odontogenic chronic rhinosinusitis undergoing maxillary extraction were retrospectively analysed. Patients with (n = 21) and without (n = 10) oroantral fistula on computed tomography were classified. Functional endoscopic sinus surgery was performed when sinusitis did not improve after extraction. The critical indicators for surgical requirement in the management of odontogenic chronic rhinosinusitis were analysed. Results Sinusitis significantly improved after extraction in both groups. Patients without oroantral fistula had significantly more severe remnant sinusitis than those with oroantral fistula after extraction on computed tomography (p = 0.0037). The requirement for functional endoscopic sinus surgery was statistically significant for patients without orofacial fistula over those with orofacial fistula (p < 0.0001). The surgical improvement ratio was 93 per cent. Conclusion The absence of oroantral fistula and severe sinusitis can be critical indicators for the requirement of functional endoscopic sinus surgery after extraction in the management of odontogenic chronic rhinosinusitis.

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