Otolaryngologists' perceptions of odontogenic maxillary sinusitis.
OBJECTIVE
Odontogenic maxillary sinusitis (OMS) is a common cause of chronic rhinosinusitis (CRS); however, the condition is infrequently mentioned in recent rhinosinusitis guidelines and often overlooked as a cause of sinusitis by otolaryngologists, dentists, and radiologists. The goal of this survey is to assess otolaryngologists' perceptions of the incidence, diagnosis, and treatment of OMS.


METHODS
Physician survey.


METHODS
Ninety-three board certified otolaryngologists in the United States completed a 17-question survey on etiologies of CRS, which also included questions on alternative diagnoses and radiologic findings to reduce respondent bias toward the survey's focus on odontogenic sinusitis. Results were compared between self-reported general otolaryngologists and rhinologists.


RESULTS
Both groups recognized an odontogenic source as a common cause of maxillary sinusitis and reported treating an average of 2.9 patients per year with OMS who were initially misdiagnosed. Most otolaryngologists surveyed perceived radiologists to never or rarely report on dental pathology in their sinus computed tomography (CT) interpretation.


CONCLUSIONS
Both general otolaryngologists and rhinologists recognize odontogenic sinusitis is common, although often initially misdiagnosed. With increasing awareness of OMS, we believe that otolaryngologists and radiologists will review sinus CT scans for the presence of periapical abscesses and dental pathology. The otolaryngologist should suspect an odontogenic etiology of purulent maxillary CRS in patients failing to improve with antibiotics, regardless of a negative dental workup.
School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. longhini.anthony@medstudent.pitt.edu
Anthony B
AB
Longhini
Barton F
BF
Branstetter
Berrylin J
BJ
Ferguson
D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D015523:Maxillary Sinusitis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D008875:Middle Aged; D010036:Otolaryngology / Q000592:standards / Q000639:trends; D010465:Perception; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000639:trends; D011786:Quality Control; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed / Q000379:methods; D014076:Tooth Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D014481:United States