CT evaluation : odontogenic origin causing obstructive maxillary sinusitis

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1 CT evaluation : odontogenic origin causing obstructive maxillary sinusitis Poster No.: C-0362 Congress: ECR 2016 Type: Scientific Exhibit Authors: G. Kim; jejusi, jejudo/kr Keywords: Emergency, Interventional vascular, Interventional non-vascular, CT-Angiography, MR-Angiography, MR-Diffusion/Perfusion, Angioplasty, Safety, Arterial access, Aneurysms, Acute, Dissection DOI: /ecr2016/C-0362 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 9

2 Aims and objectives According to previous study, Dr. yoshiura et al. reported that odontogenic maxillary sinusit is used in many situations where maxillary sinusitis and dental lesion co-exist and in korea, Sinusitis with an odontogenic source accounts for 10% of all cased of maxillary sinusitis. Because of imcomplete gathering of pathologic data, the authors defined that odontogenic disease causing sinusitis is defined as any dental or maxillary changes noted on sinus CT which is continuous to the maxillary sinus. We should be defined obstructive maxillary sinusits. Dr. Babbel et al. announce that Obstructive patterns are understandable based upon the known major routes of mucociliary drainage. obstructive patterns were designated infundibular pattern, ostiomeatal unit (OMU) pattern, sphenoethmoidal recess pattern. but because CT findings of obstructive maxillary sinutisis are indeterminated, we defined that obstructive sinusitis is defined as complete or near-complete haziness in the maxillary sinus due to obstruction of the draining pathway our study is to assist in making the correct diagnosis and treatment of odontogenic maxillary sinusitis. so we evaluate prevalence of odontogenic maxillary sinusitis causing obstructive maxillary sinusitis and it's CT imaging features Page 2 of 9

3 Methods and materials Among 736 patients who had sinus surgery from january 2009 to March 2015, the 250 patients show obstructive maxillary sinusitis on sinus CT and they are finally enrolled. All CT examinations were performed with bone algorithm and obtained axial and coronal images. We analyze obstructive pattern of maxillary sinusitis and odontogenic cause Page 3 of 9

4 Results Prevalence of odontogenic maxillary sinusitis causing obstructive sinusitis is 15% which is higher than previous study. and most common obstructive pattern of maxillary sinusitis is OMU pattern, that is 63%. Among the 38 patients, oroantral fistula were the most frequent, accounting for 70 % of cases of described odontogenic maxillary sinusitis and followed by periodontitis accouting for 21% Fig. 1: coronal CT image shows obstructive sinusitis of OMU pattern and defects (arrow) in maxillary alveolus connecting sinus antrum to oral cavity. This defect is suggesting of oroantral fistula. References: jeju national university hospital - jejusi, jejudo/kr Page 4 of 9

5 Fig. 2: Endodontic anchor of implant penetrated into sinus antrum. so that make oroantral fistula. References: jeju national university hospital - jejusi, jejudo/kr Page 5 of 9

6 Fig. 3: coronal CT image shows obstructive sinusitis of OMU pattern and periosteal lucency, especially widening of periodontal ligament and thinning of lamina dura and rounded lucency at root apex. this finding is periodontitis. References: jeju national university hospital - jejusi, jejudo/kr Page 6 of 9

7 Fig. 4: Axial CT image shows cystic lesion around crown of unerupted tooth and have focal defect suggesting rupture. coronal image shows mucocele in maxillary sinus that associated with ruptured odontogenic cyst. References: jeju national university hospital - jejusi, jejudo/kr Page 7 of 9

8 Conclusion Our results support odontogenic disease is one of important causes of obstructive maxillary sinusitis. so Concomitant management of odontogenic and sinonasal cause will ensure complete resolution and prevent its recurrence and complications. Page 8 of 9

9 References 1. Kyung Chul Lee and Sung Jin Lee Clinical Features and Treatments of Odontogenic Sinusitis Yonsei Med J 2010;51(6): , 2. K. Yoshiura, S. Ban, T. Hijiya, K. Yuasa Analysis of maxillary sinusitis using computed tomography Dentomaxillofac. Radiol., 1993;Vol. 22, Robert W. Babbel, H. Ric Harnsberger, Jerry Sonkens Recurring Patterns of Inflammatory Sinonasal Disease Demonstrated on Screening Sinus CT AJNR 1992; 13: , May/June 4. Hugoson A, Norderyd O, Slotte C, Thorstensson H. Distribution of periodontal disease in a Swedish adult population 1973, 1983 and J Clin Periodontol. 1998;25: Oscar A, Cristina B, Juan A.S, Natalia M Meta-analisis of the etiology of odontogenic maxillary sinusitis Med Oral Patol Oral Cir Bucal. 2010;15 (1):e Margaret N. Rohini N. Andrew S. Naoko Saito, Kotaro Sekiya, Takashi Kaneda, Osamu Sakai Periapical Lucency around the Tooth: Radiologic Evaluation and Differential Diagnosis, RadioGraphics 2013; 33:E15-E32 7. Stockdale CR, Chandler NP. The nature of the periapical lesion: a review of 1108 cases. J Den\-tistry 1988;16(3): Gregory V, Eleni B, Paris G, Lampros Z Endoscopic assistance in the diagnosis and treatment of odontogenic maxillary sinus disease Oral Maxillofac Surg : Page 9 of 9