title: The canine fossa puncture technique in chronic odontogenic maxillary sinusitis.
abstract: BACKGROUND
  Endoscopic sinus surgery (ESS) including middle meatus antrostomy (MMA) has been advocated as the technique of choice in the treatment of maxillary chronic odontogenic sinusitis (COS). However, recently the endoscopic canine fossa puncture (CFP) has been proposed as an alternative surgical technique of accessing the entire antrum when pathology is limited only to the maxillary sinus. This study was designed to assess the outcomes of the CFP approach versus ESS (comprising MMA) in the management of COS.
  
  
  METHODS
  A prospective study was performed on patients with COS produced by odontogenic infections (periapical granulomas or small inflammatory cysts of the molars or bicuspids), oroantral fistula (OAF), large odontogenic cysts, and maxillary foreign bodies (dental fillings, teeth roots, and implants). Patients were randomly allocated into two groups: 56 patients underwent CFP and in 54 patients the maxillary sinus was approached through MMA. After a mean follow-up of 18.5 months, recurrence rates were compared between the two groups.
  
  
  RESULTS
  During the follow-up period, OAF recurred in 10 patients: 4 in the MMA group (7.4%) and 6 in the CFP group (10.7%). The difference is not statistically significant (p = 0.39, Fisher exact test).
  
  
  CONCLUSIONS
  In patients with COS a conservative approach with avoidance of endonasal surgery is suggested: in COS without a fistula, CFP at the time of dental treatment will be sufficient. In OAF cases, CFP yielded similar results with MMA. Nevertheless, additional study with a larger sample and a longer follow-up is required to validate these results.
authors.affiliation: Second Department of Otolaryngology, University of Medicine and Pharmacy Cluj-Napoca, Romania. silviualbu63@gmail.com
authors.forename: Silviu
authors.initials: S
authors.lastname: Albu
authors.forename: Mihaela
authors.initials: M
authors.lastname: Baciut
authors.forename: Iulian
authors.initials: I
authors.lastname: Opincariu
authors.forename: Horatiu
authors.initials: H
authors.lastname: Rotaru
authors.forename: Cristian
authors.initials: C
authors.lastname: Dinu
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007239:Infections / Q000150:complications / Q000601:surgery*; D008297:Male; D008443:Maxillary Sinus / Q000002:abnormalities / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D059747:Nasal Surgical Procedures / Q000379:methods; D009807:Odontogenic Cysts / Q000150:complications / Q000601:surgery*; D011446:Prospective Studies; D011677:Punctures / Q000379:methods*; D012008:Recurrence; D012852:Sinusitis / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome