Odntogenic Sinusitis: Is The Functional Endoscopic Sinus Surgery (FESS) Mandatory?

Objective: Odontogenic maxillary sinusitis is a common inflammatory disease resulted from violating the Schneiderian membrane by conditions arising from the dento-alveolar unit. The aim of this study is to evaluate the need of Functional Endoscopic Sinus Surgery (FESS) use for the treatment of odontogenic maxillary sinusitis.

Methods: In total, 35 patients (12 females, 23 males, 37 sinuses) with odontogenic sinusitis who were treated surgically using the modified Caldwell-Luc technique as first choice modality at the department of Oral & Maxillofacial surgery at Padeh-Poriya hospital between 2014 and 2018 were assessed retrospectively for their need for FESS procedure, 5-60 months after surgery.

Results: Out of 37 cases, the need of FESS for treatment of odontogenic sinusitis was mandatory in four cases (10.8 %) due to late postoperative signs and symptoms of maxillary sinusitis. Dental implantation and/or sinus augmentation procedures were the most common etiologies for odontogenic sinusitis (22 cases, 59.5%). Foreign bodies were found in 15 cases (40.5%) and were extracted through the lateral window osteotomy during Caldwell-Luc procedure. Oral-antral fistula was presented in 22 cases (59.5%) and were not to be correlated with postoperative persistent signs of sinusitis (P=0.15). Osteomeatal complex obstruction was presented in 9 cases (24.3%) and was not correlated with postoperative persistent signs of sinusitis (P=0.57).

Conclusion: The modified Caldwell-Luc operation provides easy operative care with minimal complications. Functional odontogenic sinusitis should be used in persistent odontogenic sinusitis.