Odontogenic and rhinogenic chronic sinusitis: a modern microbiological comparison.

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Abstract

Odontogenic sinusitis and sinonasal complications of dental disease or treatment (SCDDT) play a relevant, often underappreciated role in paranasal sinus infections. Treating SCDDT patients requires tailored medical and surgical approaches in order to achieve acceptable success rates. These approaches differ from common rhinogenic sinusitis treatment protocols mostly because of the different etiopathogenesis. Our study comprehensively evaluated microbiology and antibiotic resistance in SCDDT patients and compared findings with a control group of patients affected by rhinogenic sinusitis.

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Most cited references 27

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Fungus balls of the paranasal sinuses: a review.

Pierre Grosjean, Rainer Weber (2007)

In the past 30 years, thanks in part to the advance of both endoscopic technology and imaging possibilities, the classification, diagnosis, and management of rhinosinusitis caused by fungi have been better defined. These are basically divided into invasive and non-invasive forms based on the presence or absence of microscopic evidence of fungal hyphae within the tissues. Among the non-invasive fungal sinus diseases, fungus ball has been increasingly reported and large published series have allowed better characterization of the disease and the treatment strategies. Fungus ball of the paranasal sinuses is defined as the non-invasive accumulation of dense fungal concrements in sinusal cavities, most often the maxillary sinus. To describe this entity, confusing or misleading terms such as mycetoma, aspergilloma or aspergillosis would be best avoided. Clinical presentation is non-specific and the diagnosis is usually suspected on imaging studies. Surgical treatment, usually through an endonasal endoscopic approach, is curative. In this paper, we review the clinical, radiological, and pathological presentation of the fungus ball of the paranasal sinuses as well as the surgical management with emphasis on the transnasal endoscopic approach.

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Sinusitis of odontogenic origin.

Itzhak Brook (2006)

Odontogenic sinusitis is a well-recognized condition and accounts for approximately 10% to 12% of cases of maxillary sinusitis. An odontogenic source should be considered in individuals with symptoms of maxillary sinusitis with a history of odontogenic infection, dentoalveolar surgery, periodontal surgery, or in those resistant to conventional sinusitis therapy. Diagnosis usually requires a thorough dental and clinical evaluation including appropriate radiographs. The most common causes of odontogenic sinusitis include dental abscesses and periodontal disease that had perforated the Schneidarian membrane, irritation and secondary infection caused by intra-antral foreign bodies, and sinus perforations during tooth extraction. An odontogenic infection is a polymicrobial aerobic-anaerobic infection, with anaerobes outnumbering the aerobes. The most common isolates include anaerobic streptococci and gram-negative bacilli, and Enterobacteriaceae. Surgical and dental treatment of the odontogenic pathological conditions combined with medical therapy is indicated. When present, an odontogenic foreign body should be surgical removed. Surgical management of oroantral communication is indicated to reduce the likelihood of causing chronic sinus disease. The management of odontogenic sinusitis includes a 3- to 4-week course of antimicrobials effective against the oral flora pathogens.

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Odontogenic sinusitis: an ancient but under-appreciated cause of maxillary sinusitis.

N. D. Patel, B. Ferguson (2012)

For well over 100 years, it has been appreciated that maxillary dental infections can cause sinusitis. This insight has been largely overlooked with the advent of functional endoscopic sinus surgery (ESS) and its emphasis on the osteomeatal complex. We review several recent case series and reviews of odontogenic sinusitis that characterize and discuss emerging diagnostic modalities in odontogenic sinusitis. In recent publications on odontogenic sinusitis, up to 40% of chronic bacterial maxillary sinus infections are attributed to a dental source, which is far higher than the previously reported incidence of 10%. Plain dental films and dental evaluations frequently fail to detect maxillary dental infection that can be causing odontogenic sinusitis. However, sinus computed tomography (CT) or Cone Beam Volumetric CT (CBVCT) are far more successful in identifying dental disease causing sinusitis. The microbial pathogens of odontogenic sinusitis remain unchanged from earlier reviews; however, the clinical findings in odontogenic sinusitis are better described in recent reviews. Successful treatment of odontogenic sinusitis requires management of the odontogenic source and may require concomitant or subsequent sinus surgery. Odontogenic sinusitis is frequently recalcitrant to medical therapy and usually requires treatment of the dental disease. Sometimes dental treatment alone is adequate to resolve the odontogenic sinusitis and sometimes concomitant or subsequent ESS is required. Evaluation of all patients with persistent chronic rhinosinusitis (CRS) should include inspection of the maxillary teeth on CT scan for evidence of periapical lucencies. Unilateral recalcitrant disease associated with foul smelling drainage is especially characteristic of odontogenic sinusitis. High-resolution CT scans and CBVCT can assist in identifying dental disease.

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Author and article information

Journal

Journal ID (iso-abbrev): Int Forum Allergy Rhinol

Title: International forum of allergy & rhinology

Publisher: Wiley

ISSN (Electronic): 2042-6984

ISSN (Print): 2042-6976

Publication date (Electronic): Jan 2016

Volume: 6

Issue: 1

Affiliations

[1 ] Department of Otolaryngology-Head and Neck, San Paolo Hospital, University of Milan, Milan, Italy.

[2 ] Laboratory of Clinical Chemistry and Microbiology, National Institute for Research and Treatment (IRCCS) Galeazzi Orthopaedic Institute, Milan, Italy.

[3 ] Laboratory of Technical Science for Laboratory Medicine, Department of Biomedical Science for Health, University of Milan, Milan, Italy.

Article

DOI: 10.1002/alr.21629

PubMed ID: 26345711

SO-VID: a18fa520-24a8-4519-b092-1094be55f70c

History

Keywords: bacteriology,paranasal sinus diseases,rhinosinusitis,chronic disease,medical therapy of chronic rhinosinusitis,chronic rhinosinusitis,fungal sinusitis

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Keywords: bacteriology, paranasal sinus diseases, rhinosinusitis, chronic disease, medical therapy of chronic rhinosinusitis, chronic rhinosinusitis, fungal sinusitis

Odontogenic and rhinogenic chronic sinusitis: a modern microbiological comparison.

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Jiangsu Journal of Preventive Medicine

Most cited references 27

Fungus balls of the paranasal sinuses: a review.

Sinusitis of odontogenic origin.

Odontogenic sinusitis: an ancient but under-appreciated cause of maxillary sinusitis.

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