title: Redefining boundaries in odontogenic sinusitis: a retrospective evaluation of extramaxillary involvement in 315 patients.
abstract: BACKGROUND
  Odontogenic sinusitis and "sinonasal complications of dental disease or dental treatment" (SCDDT) have been assumed to be limited to the maxillary sinus. Nevertheless, many patients also show more extensive sinonasal involvement and, occasionally, also have associated bilateral disease. We evaluated the incidence of extramaxillary extension over an 11-year period in our clinic.
  
  
  METHODS
  We retrospectively evaluated 315 surgically treated SCDDT patients. Sinonasal involvement was assessed with presurgical imaging and confirmed with intraoperative findings. Patients were subsequently categorized into 3 groups, based on the sinonasal extension.
  
  
  RESULTS
  In 40.3% of patients the sinonasal condition was limited to the maxillary sinus. Forty-one percent of patients had unilateral extramaxillary involvement, and in 18.7% of patients, we found bilateral involvement.
  
  
  CONCLUSIONS
  Complete presurgery evaluation with endoscopy and a computed tomography (CT) scan in SCDDT patients is essential. SCDDT patients not responding to medical and dental treatment should be addressed with a planned approach targeting the extramaxillary extension, which may necessitate a combined oral and endonasal approach. It is unclear whether disease in the maxillary sinus contralateral to the primary maxillary sinus demonstrating odontogenic-induced disease is incidental, associated, or represents a subclinical odontogenic infection.
authors.affiliation: Unit of Otolaryngology, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy.
authors.forename: Alberto Maria
authors.initials: AM
authors.lastname: Saibene
authors.forename: Giorgia Carlotta
authors.initials: GC
authors.lastname: Pipolo
authors.forename: Paolo
authors.initials: P
authors.lastname: Lozza
authors.forename: Alberto
authors.initials: A
authors.lastname: Maccari
authors.forename: Sara Maria
authors.initials: SM
authors.lastname: Portaleone
authors.forename: Alberto
authors.initials: A
authors.lastname: Scotti
authors.forename: Roberto
authors.initials: R
authors.lastname: Borloni
authors.forename: Francesco
authors.initials: F
authors.lastname: Messina
authors.forename: Daniele
authors.initials: D
authors.lastname: Di Pasquale
authors.forename: Giovanni
authors.initials: G
authors.lastname: Felisati
mesh_terms: D000328:Adult; D004724:Endoscopy; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy; D008297:Male; D008439:Maxillary Diseases / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D019647:Oral Surgical Procedures; D010254:Paranasal Sinus Diseases / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D009057:Stomatognathic Diseases / Q000150:complications / Q000453:epidemiology*; D014057:Tomography, X-Ray Computed
keywords: computerized tomography; cone-beam computed tomography; dental implantation; endodontics; maxillary sinusitis; paranasal sinuses disease; sinus floor augmentation; sinusitis