title: Monolateral sinonasal complications of dental disease or treatment: when does endoscopic endonasal surgery require an intraoral approach?
abstract: The widespread use of dental implants and reconstructive procedures for their positioning has led to an increase in sinonasal complications of dental disease and treatment (SCDDT). Diagnosis requires accurate dental and rhinological evaluation, including computed tomography (CT). The aim of this study is to investigate a multidisciplinary approach for the treatment of SCDDT by combining endoscopic endonasal surgery (EES) and an intraoral approach on the basis of a preliminary classification system already proposed by other authors. Moreover, we analysed the percentage of odontogenic maxillary sinusitis extending to the anterior ethmoidal sinuses and bacteria involved in the pathogenesis of SCDDT. Between January 2012 and August 2015, in our series of 31 patients, 16/31 patients (51.6%) were treated with EES, 3/31 patients (9.7%) with an intraoral approach and 12/31 patients (38.7%) with a combined approach. All patients reported improvement in sinusitis symptoms confirmed by clinical examinations and CT scan. No significant complications were recorded and revision surgery was not required. Finally, the results of this preliminary study suggest that a multidisciplinary approach to SCDDT from diagnosis to therapy allows more precise diagnosis and comprehensive therapy to achieve a rapid recovery and minimise the risk of recurrence.
authors.affiliation: ENT Dept., San Luigi Gonzaga Hospital, University of Turin, Italy.
authors.forename: G L
authors.initials: GL
authors.lastname: Fadda
authors.affiliation: Dept. of Oncology, Resident, PhD program in Experimental Medicine and Therapy, University of Turin, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Berrone
authors.affiliation: ENT Dept., San Luigi Gonzaga Hospital, University of Turin, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Crosetti
authors.affiliation: ENT Dept., San Luigi Gonzaga Hospital, University of Turin, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Succo
mesh_terms: D000328:Adult; D000368:Aged; D015921:Dental Implants / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods; D009666:Nose; D019647:Oral Surgical Procedures / Q000009:adverse effects; D010254:Paranasal Sinus Diseases / Q000097:blood*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D009057:Stomatognathic Diseases / Q000150:complications*
chemical_list: D015921:Dental Implants
keywords: Chronic rhinosinusitis; FESS; Odontogenic maxillary sinusitis; Oral implant; Sinus floor elevation