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Laryngorhinootologie 2021; 100(07): 532-541
DOI: 10.1055/a-1339-1606
Übersicht

Die dentogene Sinusitis

Sinusitis of dental origin
Jürgen Abrams 
  ENT, St. Barbara-Klinik Hamm-Heessen, Hamm, Germany
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Zusammenfassung

In den letzten Jahren wird eine steigende Anzahl odontogener Entzündungen der Kieferhöhle beobachtet. Voraussetzung für eine bakterielle Infektion der Kieferhöhle ist die Perforation der Schneider’schen Membran. Pathogenetisch ist die ostiomeatale Einheit durch die vom Kieferhöhlenboden aufsteigende Infektion erst sekundär involviert. Wichtig sind neben der Anamnese bildgebende Verfahren, wobei der hochauflösenden CT und der DVT wegen der 3-dimensionalen Auflösung eine besondere Aufgabe zukommt. Eine zahnärztliche Röntgenaufnahme oder eine zahnärztliche Untersuchung zur Diagnostik ist in vielen Fällen nicht ausreichend. Aufgrund der Anatomie sind vor allem die Molaren als Auslöser einer dentogenen Sinusitis anzusehen. Das Keimspektrum ist polymikrobiell mit einer Dominanz von Anaerobiern. Therapeutisch favorisieren wir die 1-zeitige Operation mit Sanierung des zugrunde liegenden Prozesses und funktioneller Nebenhöhlenchirurgie. Auch in der Implantologie kann die funktionelle Nebenhöhlenchirurgie einen wesentlichen Beitrag zur Sanierung entzündlicher Komplikationen leisten.

Abstract

In recent years, an increasing number of dental infections of the maxillary sinus has been observed. A prerequisite for a bacterial infection of the maxillary sinus is the perforation of Schneider’s membrane. Pathogenetically, the ostiomeatal unit is only secondarily involved due to the infection ascending from the maxillary sinus floor. Besides the anamnesis, imaging procedures are important, whereby the high-resolution CT and CBCT (cone beam CT) have a special task due to their three-dimensional resolution. A dental X-ray or a dental examination for diagnosis is not sufficient in many cases. Due to the anatomy, the molars in particular are to be regarded as the cause of dentogenic sinusitis. The germ spectrum is polymicrobial with a dominance of anaerobes. Therapeutically, we favour one-stage surgery with rehabilitation of the underlying process and functional sinus surgery. Functional sinus surgery can also make a significant contribution to the rehabilitation of inflammatory complications in implantology.

Schlüsselwörter

dentogene Sinusitis - dentogene Sinusitis/Anatomie - dentogene/Bildgebung - dentogene Sinusitis/Keime - dentogene Sinusitis/Therapie

Key words

odontogenic sinusitis - odontogenic sinusitis/anatomy - odontogenic/imaging - odontogenic sinusitis/germ - odontogenic sinusitis/therapy


Publication History

Received: 16 August 2020

Accepted: 15 December 2020

Article published online:
20 January 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Akhaddar A. et al. Orbital abscess associated with sinusitis from odontogenic origin. Intern Med 2010; 49 (05) 523-524
    CrossrefPubMedGoogle Scholar
  • 2 Longhini AB, Branstetter BF, Ferguson BJ. Otolaryngologists’ perceptions of odontogenic maxillary sinusitis. Laryngoscope 2012; 122 (09) 1910-1914
    CrossrefPubMedGoogle Scholar
  • 3 Lechien JR. et al. Chronic maxillary rhinosinusitis of dental origin: a systematic review of 674 patient cases. Int J Otolaryngol 2014; 2014: 465173
    CrossrefPubMedGoogle Scholar
  • 4 Giovannetti F. et al. Endoscopic sinus surgery in sinus-oral pathology. J Craniofac Surg 2014; 25 (03) 991-994
    CrossrefPubMedGoogle Scholar
  • 5 Hajiioannou J. et al. Maxillary sinusitis of dental origin due to oroantral fistula, treated by endoscopic sinus surgery and primary fistula closure. J Laryngol Otol 2010; 124 (09) 986-989
    CrossrefPubMedGoogle Scholar
  • 6 Schmelzeisen R. et al. Komplikationen beim plastischen Verschluss von Mund-Antrum Verbindungen. Deutsche Zahnärztliche Zeitschrift 1988; 43 (12) 1335-1337
    PubMedGoogle Scholar
  • 7 Patel NA, Ferguson BJ. Odontogenic sinusitis: an ancient but under-appreciated cause of maxillary sinusitis. Curr Opin Otolaryngol Head Neck Surg 2012; 20 (01) 24-28
    CrossrefPubMedGoogle Scholar
  • 8 Hoskison E. et al. Evidence of an increase in the incidence of odontogenic sinusitis over the last decade in the UK. J Laryngol Otol 2012; 126 (01) 43-46
    CrossrefPubMedGoogle Scholar
  • 9 Albu S, Baciut M. Failures in endoscopic surgery of the maxillary sinus. Otolaryngol Head Neck Surg 2010; 142 (02) 196-201
    CrossrefPubMedGoogle Scholar
  • 10 Matsumoto Y. et al. Association between odontogenic infections and unilateral sinus opacification. Auris Nasus Larynx 2015; 42 (04) 288-293
    CrossrefPubMedGoogle Scholar
  • 11 Krimmel M. L2k-Leitlinie odontogene Sinusitis maxillaris. 2019
    PubMedGoogle Scholar
  • 12 Eberhardt JA, Torabinejad M, Christiansen EL. A computed tomographic study of the distances between the maxillary sinus floor and the apices of the maxillary posterior teeth. Oral Surg Oral Med Oral Pathol 1992; 73 (03) 345-346
    CrossrefPubMedGoogle Scholar
  • 13 Krimmel M, Reinert S. Die laterale Kieferhöhle und die laterale Nasenwand. Der MKG Chirurg 2014; 7 (03) 170-176
    CrossrefPubMedGoogle Scholar
  • 14 Whyte A, Boeddinghaus R. Imaging of odontogenic sinusitis. Clin Radiol 2019; 74 (07) 503-516
    CrossrefPubMedGoogle Scholar
  • 15 Srouji S. et al. The Schneiderian membrane contains osteoprogenitor cells: in vivo and in vitro study. Calcif Tissue Int 2009; 84 (02) 138-145
    CrossrefPubMedGoogle Scholar
  • 16 Taschieri S. et al Pathophysiology of sinusitis of odontogenic origin. J Investig Clin Dent 2017 8 (2).
    PubMedGoogle Scholar
  • 17 Workman AD, Granquist EJ, Adappa ND. Odontogenic sinusitis: developments in diagnosis, microbiology, and treatment. Curr Opin Otolaryngol Head Neck Surg 2018; 26 (01) 27-33
    CrossrefPubMedGoogle Scholar
  • 18 Brook I. Microbiology of acute and chronic maxillary sinusitis associated with an odontogenic origin. Laryngoscope 2005; 115 (05) 823-825
    CrossrefPubMedGoogle Scholar
  • 19 Little RE. et al. Odontogenic sinusitis: A review of the current literature. Laryngoscope Investig Otolaryngol 2018; 3 (02) 110-114
    CrossrefPubMedGoogle Scholar
  • 20 Siqueira Jr JF, Rocas IN. Diversity of endodontic microbiota revisited. J Dent Res 2009; 88 (11) 969-981
    CrossrefPubMedGoogle Scholar
  • 21 Brook I. Microbiology of intracranial abscesses associated with sinusitis of odontogenic origin. Ann Otol Rhinol Laryngol 2006; 115 (12) 917-920
    CrossrefPubMedGoogle Scholar
  • 22 Maresch G. et al. [Etiology of odontogenic maxillary sinusitis]. HNO 1999; 47 (08) 748-755
    CrossrefPubMedGoogle Scholar
  • 23 Fanucci E. et al. Diagnosis and treatment of paranasal sinus fungus ball of odontogenic origin: case report. Oral Implantol (Rome) 2013; 6 (03) 63-66
    PubMedGoogle Scholar
  • 24 Beck-Mannagetta J, Necek D. Radiologic findings in aspergillosis of the maxillary sinus. Oral Surg Oral Med Oral Pathol 1986; 62 (03) 345-349
    CrossrefPubMedGoogle Scholar
  • 25 Costa F. et al. Endoscopic surgical treatment of chronic maxillary sinusitis of dental origin. J Oral Maxillofac Surg 2007; 65 (02) 223-228
    CrossrefPubMedGoogle Scholar
  • 26 Longhini AB, Branstetter BF, Ferguson BJ. Unrecognized odontogenic maxillary sinusitis: a cause of endoscopic sinus surgery failure. Am J Rhinol Allergy 2010; 24 (04) 296-300
    CrossrefPubMedGoogle Scholar
  • 27 Mack MG. et al. [Imaging in inflammatory diseases of the paranasal sinuses]. Radiologe 2007; 47 (07) 606-612
    CrossrefPubMedGoogle Scholar
  • 28 Shahbazian M, Jacobs R. Diagnostic value of 2D and 3D imaging in odontogenic maxillary sinusitis: a review of literature. J Oral Rehabil 2012; 39 (04) 294-300
    CrossrefPubMedGoogle Scholar
  • 29 Schippers CG. Die Therapieergebnis der odontogenen Sinusitis maxillaris an der Kölner Klinik von 1971–1987. Deutsche zahnarztliche Zeitschrift 1988; 43 (12) 1298-1300
    PubMedGoogle Scholar
  • 30 Longhini AB, Ferguson BJ. Clinical aspects of odontogenic maxillary sinusitis: a case series. Int Forum Allergy Rhinol 2011; 1 (05) 409-415
    CrossrefPubMedGoogle Scholar
  • 31 Pokorny A, Tataryn R. Clinical and radiologic findings in a case series of maxillary sinusitis of dental origin. Int Forum Allergy Rhinol 2013; 3 (12) 973-979
    CrossrefPubMedGoogle Scholar
  • 32 Lopatin AS. et al. Chronic maxillary sinusitis of dental origin: is external surgical approach mandatory?. Laryngoscope 2002; 112 (06) 1056-1059
    CrossrefPubMedGoogle Scholar
  • 33 Hüttenbrink KB, Clemens S. Spätfolgen der Caldwell-Luc Operation. Laryngo-Rhino-Otologie 1986; 65 (02) 69-73
    Article in Thieme ConnectPubMedGoogle Scholar
  • 34 Hartstock M, Herrmann A. Akute Rhinosinusitis als Folge einer Mund-Antrum-Verbindung. Zahnärztliche Mitteilungen 2015; 105 (18) 36-40
    PubMedGoogle Scholar
  • 35 Kim SM. Definition and management of odontogenic maxillary sinusitis. Maxillofac Plast Reconstr Surg 2019; 41 (01) 13
    CrossrefPubMedGoogle Scholar
  • 36 Weber RK. Aktueller Stand der endonasalen Nebenhöhlenchirurgie. Laryngo-Rhino-Otologie 2015; 94 (Suppl. 01) 64-142
    Article in Thieme ConnectPubMedGoogle Scholar
  • 37 Schley JS, Terheyden H, Wolfart S. S3-Leitlinie: Implantatprothetische Versorgung des zahnlosen Oberkiefers. 2013
    PubMedGoogle Scholar
  • 38 Troeltzsch M. et al. Etiology and clinical characteristics of symptomatic unilateral maxillary sinusitis: A review of 174 cases. J Craniomaxillofac Surg 2015; 43 (08) 1522-1529
    CrossrefPubMedGoogle Scholar