치성 부비동염의 치료 전략

Abstract

The treatment options of odontogenic sinusitis are medical treatment, endoscopic sinus surgery (ESS) and dental treatment. The aim of this study is to determine whether dental treatment alone is sufficient or whether patients will eventually require ESS for odontogenic sinusitis treatment. A retrospective review performed of 37 patients with odontogenic sinusitis. Multiple factors including demographic factors, symptoms, endoscopic and CT findings, clinical course and management were analyzed. The patients lost during their follow-up or whose medical records omitted until the completion of treatment were excluded. Among total 29 patients who underwent dental treatment only or before ESS, 65.5%(19 patients) cured with dental treatment alone and 34.5%(10 patients) required ESS after failure of dental treatment. Eight patients was treated with ESS before dental treatment. Patients who smoke (p=0.036) and patients with higher Lund-Mackay score on CT finding (p=0.003), more severe purulent rhinorrhea score (p=0.047) required ESS after failure of dental treatment with statistical significance. Because odontogenic sinusitis is often improved by dental treatment alone, odontogenic sinusitis should be preceded by dental treatment and ESS should be performed after failure of dental treatment. However, if the CT findings show severe sinusitis, dental treatment alone will not improve the condition, so early ESS may be considered.