Our Summary

This research paper discusses a study conducted on the treatment of a common disease called odontogenic sinusitis (OS), which is often seen by ear, nose, and throat specialists and oral surgeons. The disease is caused by problems with teeth, but there’s no universally agreed-upon treatment method. The study looked specifically at the results of a particular type of surgery used to treat OS, called endoscopic sinus surgery (ESS), combined with another procedure known as endoscopic apicoectomy.

The researchers included 21 patients who had ESS in the study. Of these, 11 also had the apicoectomy at the same time and were considered the main group for the study. The other 10 had the problematic teeth removed either before or during the surgery and were used as a comparison group.

The main outcome the researchers were interested in was what happened to the teeth after surgery. They used regular X-rays to assess this. They also compared what happened with the sinuses in both groups after surgery.

In the main group, 17 teeth had the apicoectomy during the ESS. The treatment was successful in 16 out of these 17 cases (94.1%). This success rate is similar to what’s been reported in previous studies of this type of microsurgery. In terms of the sinuses, 10 out of the 11 patients (90.9%) had good results after surgery, with the average healing time for the sinus lining being around 6.9 weeks. These results were not significantly different from those in the comparison group.

The researchers concluded that this combined surgical approach could be a good option for treating OS, as it allows the problematic teeth to be preserved without negatively affecting the successful treatment of the sinusitis. They suggest that a collaborative approach involving both ear, nose, and throat specialists and oral surgeons would be the best way to treat this disease.

FAQs

  1. What is odontogenic sinusitis (OS) and how is it typically managed?
  2. What is the success rate of endoscopic apicoectomy used in conjunction with endoscopic sinus surgery (ESS) for the treatment of OS?
  3. Does the surgical procedure for OS have any impact on the successful treatment of sinusitis?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sinus surgery is to follow all post-operative instructions carefully, including any prescribed medications, nasal rinses, and activity restrictions. It is important to attend all follow-up appointments to monitor healing and address any concerns. Additionally, maintaining good oral hygiene and addressing any dental issues promptly can help prevent future cases of sinusitis.

Suitable For

Patients with odontogenic sinusitis who have failed conservative treatment and have periapical lesions on their teeth are typically recommended for sinus surgery. In particular, patients who have persistent symptoms such as facial pain, pressure, congestion, and purulent nasal discharge may benefit from endoscopic sinus surgery (ESS) with endoscopic apicoectomy. This combined approach allows for the treatment of both the sinusitis and the underlying dental infection, leading to improved outcomes and preservation of the causative teeth. This surgical procedure has been shown to have high success rates in treating periapical lesions and improving sinus symptoms, making it a valuable option for patients with odontogenic sinusitis.

Timeline

Before sinus surgery:

  • Patient experiences chronic sinusitis symptoms such as nasal congestion, facial pain, headache, and postnasal drip
  • Patient may undergo imaging studies such as CT scans to confirm the diagnosis of sinusitis
  • If odontogenic sinusitis is suspected, patient may be referred to an oral surgeon for evaluation of the causative teeth
  • Decision is made to proceed with endoscopic sinus surgery (ESS) with or without additional dental procedures

After sinus surgery:

  • Patient undergoes ESS to clear out the sinuses and remove any obstructions
  • In some cases, endoscopic apicoectomy is performed simultaneously to address any periapical lesions in the causative teeth
  • Patient may experience some postoperative discomfort and nasal congestion, which typically resolves within a few weeks
  • Follow-up appointments are scheduled to monitor the healing of the sinuses and teeth
  • Overall, the surgical procedure is successful in treating sinusitis and preserving the causative teeth, with good outcomes in terms of sinus and tooth healing.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with sinus surgery?
  2. How long is the recovery period after sinus surgery?
  3. Will I need to take any medications before or after the surgery?
  4. What are the expected outcomes of the surgery in terms of improving my sinus symptoms?
  5. What alternative treatment options are available for my sinus condition?
  6. How experienced are you in performing sinus surgery, specifically in cases of odontogenic sinusitis?
  7. Will I need any additional procedures, such as endoscopic apicoectomy, during the sinus surgery?
  8. How many patients have you treated with odontogenic sinusitis, and what have been the success rates?
  9. How will you monitor my progress and follow up after the surgery?
  10. Are there any lifestyle changes or precautions I should take after the surgery to prevent recurrence of sinus issues?

Reference

Authors: Akiyama K, Nakai Y, Samukawa Y, Miyake M, Hoshikawa H. Journal: J Craniofac Surg. 2019 Jan;30(1):239-243. doi: 10.1097/SCS.0000000000005134. PMID: 30444772