Chronic Odontogenic Paranasal Sinusitis in the Material Provided by the Otorhinolaryngology Unit of the 4th Military Teaching Hospital in Wroclaw

Background. The aim of this work is to prepare a dental diagnostic standard that would enable us to distinguish patients with chronic odontogenic sinusitis (COS) from patients with sinusitis of other origin. We also wanted to determine a realistic number of COS in the Polish population.Objectives. The diversity of symptoms presented in COS does not differ from chronic sinusitis of other origin. However, the microbiological and pathophysiological differences extort a specific diagnostic approach and treatment. This is why odontogenic sinusitis is considered to be an independent disease. The basic method used to diagnose odontogenic foci is an orthopantomogram (OPM), but CB-CT is currently becoming a more common option. A proper diagnostic route enables correct problem identification and implementation of the best treatment method. Endoscopic sinus surgery (ESS) is an effective way of treating up to 85% of patients. Postoperative lack of success may be associated with odontogenic foci, which is why it is highly important to exclude this infection focus in the preliminary qualification for surgery.Material and methods. Our study group consisted of 72 patients preliminary qualified for ESS on the Otolaryngological Unit of the 4th Military Teaching Hospital in Wroclaw because of chronic sinusitis. Patients after initial qualification were referred to dental surgery outpatient clinic for exclusion of potential odontogenic changes. The evaluation was performed by a group of qualified doctors and based on a clinical examination and radiological imaging (sinus CT, ortopantomogram, other radiograms). Acquired data was analyzed statistically.Results. Odontogenic foci were found in 86.1% patients (62 cases) with chronic sinusitis. Lack of odontogenic foci was stated only in 13.9% patients (10 cases). There were no statistical differences in the number of inflammatory foci between men and women.Conclusions. The lack of treatment standards in COS forces us to create good interdisciplinary preoperative cooperation between head and neck surgeons, radiologists and chronic sinnsitis