2025 Poster Presentations
P040: ODONTOGENIC SINUSITIS: AN UNDER RECOGNIZED SOURCE OF COMPLICATED SINUSITIS
Danielle Golub, MD; Amir Dehdashti, MD; Katherine Dempsey, MD; Aron Pollack, MD; Charles Tong, MD; Judd Fastenberg, MD; Mark B Chaskes, MD, MBA; Northwell Health
Background: Odontogenic sinusitis (ODS) is a more common clinical entity than historically reported and is under-represented in the literature. While this unique subtype of infectious sinusitis is most often chronic with varying degrees and severity of sinonasal symptoms, it can present acutely (or as acute on chronic) with orbital, intracranial, or osseous infectious complications. Given the overall paucity of literature with respect to ODS, and an even greater understudy of complicated ODS, the incidence is not well understood. Further, dental disease is likely often under-recognized as the etiology of complicated sinusitis. The purpose of this study is to both bring attention to, and to report on the incidence of, complicated ODS.
Methods: A retrospective chart review of patients who underwent endoscopic sinus surgery for ODS and/or extrasinus complications of sinusitis at a tertiary medical center was performed from January 1, 2024 – June 30, 2024. Outcomes were reviewed.
Results: A total of 13 patients with ODS were treated by endoscopic sinus surgery in the 6 month inclusion window. Of these, 4/13 (30.7%) had complicated ODS - 1 intraorbital, 1 intracranial, and 2 osseous complications. Further, during the 6 month inclusion window, 8 patients were treated with complex sinusitis of all etiologies - 4 intraorbital abscesses, 1 intracranial abscess, 2 osseous complications, and 1 with both intraorbital and intracranial abscess. Of the patients with extrasinus complications of sinusitis, 50% were of odontogenic origin. At the time of initial surgery, the dental component was not addressed in any of these patient. There were 2 instances of initial surgical failure. One patient was returned to OR with dental extraction and resolution of disease. The other treatment failure was lost to follow up prior to addressing odontogenic source.
Conclusion: Extrasinus complications of odontogenic sinusitis may be more common than previously reported. Further, in patients with intraorbital, intracranial, or osseous complications of sinusitis, a dental source may be more common than previously recognized, and must be closely considered. As demonstrated, surgical management of the sinusitis and the acute extrasinus complication alone may yield suboptimal outcomes if the dental source is not concurrently managed.