Chronic maxillary sinusitis of dental origin: is external surgical approach mandatory?
OBJECTIVE
The study evaluated a minimally invasive endoscopic shaver-assisted technique for treatment of chronic maxillary sinusitis of dental origin.


METHODS
A retrospective multicenter chart review was performed at two clinics of all patients who had a diagnosis of chronic maxillary sinusitis of dental origin and were treated using the technique.


METHODS
The patients were divided into two main groups: patients with and without chronic oral antral fistula. Data from the patients were collected and analyzed.


RESULTS
Seventy patients aged 16 to 62 years had surgery using the endoscopic technique. Thirty-nine patients presented with oral antral fistula of different locations, the most common being third molar fistula (26 cases). Foreign bodies were found in 21 sinuses, among them teeth roots (in 11), dental fillings (in 7), and packs (in 3). Fungal ball was found in six sinuses. The surgical technique included retrograde resection of the uncinate process, enlargement of the natural maxillary ostium posteriorly, and removal of the polyps and foreign bodies from the sinus through the middle meatal antrostomy window. Approach through the oral antral fistula facilitated additional access to the alveolar recess. Removal of polyps from the alveolar recess was performed using the microdebrider, which was introduced through the fistula under endoscopic control through the nasoantral window. The fistula was closed in two layers. Good results were obtained in all but four patients in terms up to 3 years. No complications occurred. Overall recovery rate after primary surgery was 94.7%.


CONCLUSIONS
Endoscopic approach to chronic maxillary sinusitis of dental origin is a new, reliable method associated with less morbidity and lower incidence of complications.
Lopatin
Andrey S
AS
Otorhinolaryngology Department, Central Hospital, Presidential Medical Center, Moscow, Russia. asl@cch.pmc.ru
Sysolyatin
Svyatoslav P
SP
Sysolyatin
Pavel G
PG
Melnikov
Mikhail N
MN
D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D003751:Dental Fistula / Q000150:complications* / Q000601:surgery; D004724:Endoscopy; D006801:Humans; D008443:Maxillary Sinus / Q000601:surgery; D015523:Maxillary Sinusitis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome