Evaluation of clinical and imaging results in patients with chronic odontogenic rhinosinusitis

Abstract

Introduction: Chronic odontogenic rhinosinusitis (CORS) is an inflammatory/infectious process of the nasal mucosa and sinuses of dental origin. Actually, it corresponds to an underdiagnosed pathology. The gold standard diagnosis is computed tomography. The treatments differ, from isolated medical treatment to medical-surgical sinuses or combined. Aim: To characterize the clinical and imaging results of patients with CORS accor­ding to the treatment received, to establish therapeutic recommendations. In addition to describing the frequency of subdiagnosis of this pathology. Material and method: Descriptive, retrospective study. Patients with clinical and imaging diagnosis of CORS between 2013-2017 were included in a private medical care center, to whom a cone beam computed tomography control was performed. Those with chronic rhinosinusitis, previous functional endoscopic sinus surgery (FESS), can­cer, pregnant women, rejection of cone beam computed tomography, absence of pre­operative images and those under 18 years were excluded. Results: Of all patients operated on FESS (n =24; 89%) the total resolution of the symptoms was 20/24 (83%), partial resolution 3/24 (12.5%) and persistence of the symptoms a 1/24 (4%). Discussion: 22/27 (81%) of patients with CORS had not reported the dental focus in the radiological report despite being visible. Those patients with post-treatment symp­toms had identified factors such as bilaterality, general bad teeth, lack of combination of dental treatment and FESS. Conclusion: The FESS combined with concomitant dental treatment, has a high degree of radiological and clinical success in this pathology. It was not possible to de­monstrate whether exodontia with closure of oroantral fistula is always required or if patients can be selected for a more conservative treatment.