Odontogenic sinusitis and sinonasal complications of dental treatments: a retrospective case series of 480 patients with critical assessment of the current classification

The term odontogenic sinusitis (OS) has proved less and less suitable to describe a series of pathological conditions related to dental procedures. We have introduced the term and classification ‘sinonasal complications of dental disease or treatment’ (SCDDT). This study aimed to review our cases and evaluate whether the classification used is applicable to everyday clinical practice. The sample was composed of patients treated for SCDDT from 2002 to 2018 in our Department of Otorhinolaryngology. All presented signs and symptoms of sinusitis and had a recent history of dental disease or treatment. All patients underwent multidisciplinary evaluation, flexible endoscopy and computed tomography (CT) scan. Patients were allocated into three groups depending on the aetiology of the complication, following the classification proposed by Felisati et al. The sample comprised 480 patients (44% men, 56% women) with a mean age of 52.36 years. Of these, 43 patients (9%) belonged to group 1 (class A), 105 (21%) to group 2 (50, 2A; 5, 2B; 27, 2C; 23, 2D) and 332 (70%) to group 3 (119, 3A; 213, 3B). A total of 454 patients (94.5%) had unilateral maxillary opacification, while only 26 cases (5.4%) started as bilateral inflammation. Nine of the latter cases (34.6%) presented a bilateral odontogenic focus, while the other 17 (65.4%) had a history of unilateral dental pathology. The results of this study suggest that SCDDT is a complex entity that needs a careful diagnostic approach based on CT scans and presurgical endoscopy.