Iatrogenic Sinonasal Oral Pathology

Oral surgery is compounded by safe and well-known techniques and presents a low rate of complications. When the superior alveolar ridge is approached, surgery may result in oroantral or oronasal fistula with or without teeth, implants or endodontic material dislocation in the maxillary sinus. Those conditions, to whom we refer as iatrogenic sinonsasal oral pathology, can lead, but not necessarily, to the development of a maxillary sinusitis that, if underestimated, may evolve in orbital cellulitis and/or cerebritis or cerebral abscess. We analysed and compare the cases referred to our institution from 2005 and 2018. The collected study group consisted of 110 patients: 48 females and 62 males patients aged 43 to 80 years (mean, 63 years). All had undergone oral surgery before our first visit: 37 patients had a prosthetic implant surgery (18 lateral-approach sinus augmentation and 20 implant placement). Thirty-three patients had tooth extractions, 12 did root canal treatments, and 29 had sinus maxillary augmentation. We define three groups of patients and outline for each group e proper algorithm of treatment. As for the better surgical choice, we found functional endoscopic sinus surgery to be better than the Caldwell-Luc technique in treating iatrogenic maxillary sinusitis. Advantages of FESS are the less invasivity, the preservation of sinus anatomy and physiology, the reduction of recovery time, and oral rehabilitation without loosening efficacy compared with the previous transoral approach.