odontogenic maxillary sinusitis

  • 文章类型: Case Reports
    牙源性鼻窦炎是孤立性上颌窦炎的最常见原因。准确的诊断对于确保最佳治疗非常重要。我们讨论了一名55岁的牙源性鼻窦炎和相关的眶下神经神经病的独特表现。我们记录了他后来的慢性上颌肺不张的发展,并讨论了可能的潜在病理生理学将其与眶下神经病联系起来。
    Odontogenic sinusitis is the most common cause of isolated maxillary sinusitis. Accurate diagnosis is important to ensure optimal treatment. We discuss the unique presentation of a 55-year-old man with odontogenic sinusitis and associated infraorbital nerve neuropathy. We document his later development of chronic maxillary atelectasis and discuss the possible underlying pathophysiology linking this with his infraorbital neuropathy.
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  • 文章类型: Journal Article
    细菌性牙源性鼻窦炎(ODS)由上颌牙问题或口腔手术引起,至少影响上颌窦,有或没有其他鼻旁窦受累。历史上一直被低估了,与最近的发现相反,将25-40%的慢性上颌窦炎归因于牙齿原因。牙髓感染是ODS的最常见原因之一。根管感染和微生物接近窦腔的根管因素起着关键作用。宿主免疫反应进一步塑造疾病的严重程度和进展。本文旨在探讨引起ODS的牙髓感染的复杂性,阐明解剖学,微生物,和免疫学方面。
    Bacterial odontogenic sinusitis (ODS) arises from maxillary dental issues or oral procedures, and affects at least the maxillary sinuses, with or without other paranasal sinus involvement. It has been historically underreported, in contrast to more recent findings attributing 25-40% of chronic maxillary sinusitis to dental causes. Endodontic infections represent one of the most common causes of ODS. Endodontic factors like root canal infection and microbial proximity to sinus cavities play pivotal roles. Host immunological responses further shape disease severity and progression. This article aims to explore the complexity of endodontic infections that cause ODS, elucidating anatomical, microbial, and immunological aspects.
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  • 文章类型: Journal Article
    背景:由于病原体的不同,鼻窦炎的亚型具有不同的症状和预后。牙源性上颌窦炎(OMS)主要发生在单侧,在临床特征上不同于通常发生在双侧的慢性鼻-鼻窦炎(CRS)。然而,OMS和CRS之间的全面微生物比较从未被系统地进行过,并且大多数比较在方法上存在偏差。本研究旨在通过荟萃分析方法对与OMS和CRS相关的微生物学进行全面分析,以便从微生物学角度为OMS和CRS的鉴别诊断提供证据。
    方法:从PubMed和CNKI数据库开始至2023年7月进行搜索。采用随机效应模型来得出已识别的细菌物种或属的合并患病率估计值。
    结果:代表的17项研究包括6项关于OMS,12关于CRS,和4个关于正常鼻窦,产生191、610和92个样本,分别。虽然没有统计学意义,与CRS相比,OMS中肽链球菌和普雷沃氏菌的患病率普遍较高.值得注意的是,与CRS相比,梭杆菌被鉴定为OMS中患病率明显更高的唯一属。
    结论:与CRS相比,OMS中的梭杆菌明显更普遍,而金黄色葡萄球菌在CRS中比在OMS中更普遍。细菌谱的这种差异可能部分解释了观察到的独特病理,并有助于开发OMS中诊断和治疗干预的新策略。
    BACKGROUND: Subtypes of sinusitis have different symptoms and prognoses due to different pathogens. Odontogenic maxillary sinusitis (OMS) mainly occurs unilaterally and is different from chronic rhinosinusitis (CRS) usually occurring bilaterally in terms of clinical characteristics. However, comprehensive microbiological comparisons between OMS and CRS have never been systematically conducted and most comparisons are methodologically biased. This study aims to provide a comprehensive analysis of the microbiology associated with OMS and CRS through a meta-analysis approach in order to provide evidence for differential diagnosis of OMS and CRS from a microbiological perspective.
    METHODS: The databases PubMed and CNKI were searched from their inception to July 2023. A random-effects model was employed to derive the pooled prevalence estimates of the identified bacterial species or genera.
    RESULTS: The 17 represented studies included 6 concerning OMS, 12 concerning CRS, and 4 concerning normal sinus, yielding 191, 610, and 92 samples, respectively. Though not statistically significant, the prevalence of Peptostreptococcus and Prevotella was generally higher in OMS compared to CRS. Notably, Fusobacterium was identified as the only genus with a significantly higher prevalence in OMS compared to CRS.
    CONCLUSIONS: Fusobacterium was significantly more prevalent in OMS compared with CRS, while Staphylococcus aureus was more prevalent in CRS than in OMS. Such differences in bacterial profile may partly explain the distinct pathology observed and contribute to the development of novel strategies for diagnosis and therapeutic interventions in OMS.
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  • 文章类型: Journal Article
    背景:牙源性上颌窦炎(OMS)在牙科和耳鼻咽喉科领域都得到了广泛认可。最近,医源性牙源性上颌窦炎可以经常遇到。这项研究的目的是通过比较CBCT和症状的术前和术后体积测量,评估使用小侧窗入路对牙源性上颌窦炎患者进行口内冲洗的效果。我们调查了2016年至2022年在PNUDH口腔颌面外科就诊的21例患者。所有患者的信息都是从电子数据库中提取的。包括随访时间为2个月或更长时间的患者。使用ImageJ程序(美国国立卫生研究院,威斯康星大学)。
    结果:在21例患者中,16人(76.1%)为男性,5名(23%)为女性。最常见的手术类型是全身麻醉(16例),其中7例有口窦瘘。在上颌窦炎的原因中,有七名植入物相关患者,五名拔牙患者,7名植骨患者,和其他组的两名患者。鼻窦冲洗后,射线照相不透明度降低了40.15%,尤其是在植骨和拔牙病例中。临床上,17例(80.9%)患者症状得到改善。
    结论:通过这项研究,可以得出结论,小侧窗入路上颌窦冲洗是临床和放射学上有效的治疗牙源性上颌窦炎的方法。
    BACKGROUND: Odontogenic maxillary sinusitis (OMS) is widely acknowledged in both the dentistry and otolaryngology fields. Recently, iatrogenic odontogenic maxillary sinusitis cases can be encountered frequently. The purpose of this study was to evaluate the effect of intraoral sinus irrigation using the small lateral window approach in patients with odontogenic maxillary sinusitis by comparing pre- and postoperative volumetric measurement of CBCT and symptoms. We surveyed 21 patients who visited the Oral and Maxillofacial Surgery Department at PNUDH from 2016 to 2022. All the patients\' information was extracted from an electronic database. The patients with a follow-up period of 2 months or more were included. The three-dimensional volumetric measurement was performed using the ImageJ program (National Institute of Health, University of Wisconsin).
    RESULTS: Among 21 patients, 16 (76.1%) were male, and 5 (23%) were female. The most common type of surgery was general anesthesia (16 cases) in which oroantral fistula was present in 7 cases. In the causes of maxillary sinusitis, there were seven implant-related patients, five patients of tooth extraction, seven patients of bone grafting, and two patients in other groups. Radiographic opacity decreased by 40.15% after sinus irrigation especially in bone graft and tooth extraction cases. Clinically, symptoms improved in 17 patients (80.9%).
    CONCLUSIONS: By this study, it can be concluded that maxillary sinus irrigation using the small lateral window approach is a clinically and radiologically effective treatment method for odontogenic maxillary sinusitis.
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  • 文章类型: Journal Article
    目的:牙源性上颌窦炎是临床上流行的疾病,但通常需要进行根治性手术和内窥镜手术。在本研究中,我们首次比较了在冲洗或不冲洗拔牙窝的情况下拔牙的疗效。
    方法:共有60例患者进行了病因牙拔除。其中,34名患者接受了灌洗,而其他26例患者没有。根据计算机断层扫描(CT)图像,治疗效果由剩余上颌窦粘膜病变的百分比量化.治疗效果的程度在五个等级后进行评估,基于剩余病变的百分比:1级(0%)(病变消失),2级(约10%),3级(约30%),4级(约50%)和5级(100%)(病变无改善)。
    结果:灌洗可显著提高拔牙治疗上颌窦粘膜病变的疗效(平均级别:从3.27降至1.35)。
    结论:拔牙和冲洗的结合可能有助于减少上颌窦手术的必要性。
    OBJECTIVE: Odontogenic maxillary sinusitis is a clinically popular disease, but radical surgery and endoscopic surgery are often required. In the present study, we compared for the first time the therapeutic efficacy of the extraction of causative teeth with or without irrigation of the extraction fossa.
    METHODS: A total of 60 patients underwent extraction of causative tooth. Among them, 34 patients underwent irrigation, while other 26 patients did not. Based on computed tomography (CT) images, treatment efficacy was quantified by the percentage of the remaining maxillary sinus mucosal lesions. The extent of therapeutic efficacy was evaluated following five grades, based on the percentage of remaining lesions: Grade 1 (0%) (disappearance of lesions), Grade 2 (roughly 10%), Grade 3 (roughly 30%), Grade 4 (approximately 50%) and Grade 5 (100%) (no improvement of the lesions).
    RESULTS: Irrigation significantly augmented the therapeutic efficacy of tooth extraction for maxillary sinus mucosal lesions (mean grade: decreasing from 3.27 to 1.35).
    CONCLUSIONS: The combination of tooth extraction and irrigation may contribute to the reduction of the necessity of surgery for the maxillary sinuses.
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  • 文章类型: Case Reports
    一种累及胸锁关节关节炎的侵袭性肺炎球菌疾病,腰椎椎间盘炎,和由青霉素耐药的肺炎链球菌引起的肌肉脓肿以前没有报道.我们通过手术引流和清创术成功治疗了一名57岁的男性,和椎板切除术/开窗术,根据血培养结果与两种静脉内抗菌药物联合给药。腰椎减压后获得临床分辨率,对左下肢的限制最小。这种治疗方法应该根据病原体来考虑,潜在的宿主因素,以及疾病的严重程度。
    An invasive pneumococcal disease involving sternoclavicular joint arthritis, lumbar spondylodiscitis, and muscular abscesses caused by penicillin-resistant Streptococcus pneumoniae has not been reported previously. We successfully treated a 57-year-old man with this condition using surgical drainage and debridement, and laminectomy/fenestration, in combination with the administration of two IV antimicrobial drugs based on blood culture results. Clinical resolution was obtained after decompression of the lumbar spine, with minimal restriction of the left lower limb. This treatment approach should be considered depending on the pathogen, underlying host factors, and the severity of the disease.
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  • 文章类型: Journal Article
    背景:这篇综述旨在提供锥束计算机断层扫描(CBCT)和其他成像方式在诊断牙源性上颌窦炎(OMS)中的当前应用的最新概述。此外,总结了OMS诊断中X线摄影方式的临床操作流程,目的是帮助临床医生提高临床实践中OMS诊断的准确性。
    方法:对X线照相方式在OMS诊断中的应用进行了全面综述。本次审查对相关信息进行了评估和组织。
    结果:CBCT提供了优越的,高分辨率,与常规X线照相方式相比,上颌牙齿-骨-窦复合体的三维视图。它可以更好地理解和分类根尖/根尖周围病变与上颌窦之间的空间关系。使用CBCT,结合其他射线照相方式和适当的图像解释的优点,对于提高OMS诊断准确性和降低漏诊或误诊的风险是必不可少的。
    结论:CBCT在口腔颌面部疾病诊断中的意义已得到广泛认可。它为OMS提供了高度精确的诊断信息和分类依据。影像学检查的临床操作程序对于确保诊断的一致性和可靠性至关重要。
    BACKGROUND: This review aims to provide an up-to-date overview of the current applications of cone-beam computed tomography (CBCT) and other imaging modalities in diagnosing odontogenic maxillary sinusitis (OMS). Furthermore, the clinical operation procedures of radiography modalities in OMS diagnosis were summarized, with the goal of assisting clinicians in improving OMS diagnostic accuracy in clinical practice.
    METHODS: A comprehensive review of researches that discussed the applications of radiography modalities in the diagnosis of OMS was conducted. Pertinent information was evaluated and organized for this review.
    RESULTS: Cone-beam computed tomography (CBCT) offers a superior, high-resolution, and three-dimensional view of the maxillary tooth-bone-sinus complex compared to conventional radiography modalities. It enables a better understanding and classification of the spatial relationships between root apices/periapical lesions and maxillary sinus. The use of CBCT, combined with the advantages of other radiography modalities and proper image interpretation, is indispensable to enhance OMS diagnostic accuracy and mitigate the risk of missed or misdiagnosis.
    CONCLUSIONS: The significance of CBCT in the diagnosis of oral and maxillofacial conditions has garnered widespread recognition. It provides highly precise diagnostic information and classification basis for OMS. The clinical operation procedures for imaging examination are essential in ensuring the consistency and reliability of the diagnosis.
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  • 文章类型: Case Reports
    内源性眼内炎是眼睛内的细菌或真菌感染,包括玻璃体和房水。胰腺炎是内源性眼内炎的一种亚型,也包括眼眶邻近软组织的感染。我们介绍了一例91岁的女性,最初表现为左眼疼痛和视力下降。发现她患有牙源性上颌窦炎继发的全眼炎。据我们所知,在文献报道之前,没有一例病例证实全眼炎和牙源性上颌窦炎之间存在这种关联.
    Endogenous endophthalmitis is a bacterial or fungal infection within the eye that includes the vitreous and aqueous humors. Panophthalmitis is a subtype of endogenous endophthalmitis that also includes infection of the adjacent soft tissue of the orbit. We present a case of a 91-year-old female who initially presented with left eye pain and decreased vision. She was found to have panophthalmitis secondary to odontogenic maxillary sinusitis. To our knowledge, there has not been a case reported in the literature before that has established this association between panophthalmitis and odontogenic maxillary sinusitis.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    未经证实:牙源性上颌窦炎(OMS)是耳鼻咽喉科和口腔颌面外科中公认的疾病。根据牙科疾病的存在和影像学评估对其进行全面诊断。尽管该疾病涉及牙齿和耳鼻咽喉科特征的组合,在OMS的初始治疗中,尚未建立适当的标准来优先考虑牙科手术。我们调查了计算机断层扫描(CT)评分,包括Lund-Mackay的得分,可以帮助优先考虑拔牙作为OMS的初始治疗。
    UNASSIGNED:我们还调查了32例仅通过拔牙治疗的OMS患者的影像学特征。评估OMS病例的提取前后CT图像。
    UNASSIGNED:术后愈合患者拔牙前的Lund-Mackay评分明显低于未愈合患者。此外,筛窦前后及额窦的CT评分,拔牙前获得的,术后治愈的患者明显低于未治愈的患者。
    未经批准:集体,筛窦和额窦的Lund-Mackay和CT评分较低与单纯拔牙治疗OMS的愈合显著相关。鼻窦CT评分可以帮助确定OMS的治疗策略。
    UNASSIGNED: Odontogenic maxillary sinusitis (OMS) is a well-recognized disease in otolaryngology and oral and maxillofacial surgery. It is diagnosed comprehensively based on the presence of dental disease and radiographic evaluation. Although the disease involves a combination of dental and otorhinolaryngological features, appropriate criteria have not been well established for prioritizing dental procedures in the initial treatment of OMS. We investigated whether computed tomography (CT) score, including the Lund-Mackay score, can help prioritize tooth extraction as the initial treatment for OMS.
    UNASSIGNED: We also investigated the radiographic features of 32 patients with OMS treated by tooth extraction alone. Both pre-and post-extraction CT images of OMS cases were evaluated.
    UNASSIGNED: Lund-Mackay scores before tooth extraction were significantly lower in postoperatively healed patients than in non-healed patients. Furthermore, CT scores of the anterior and posterior ethmoid sinuses and frontal sinuses, obtained before tooth extraction, were significantly lower in postoperatively healed patients than in non-healed patients.
    UNASSIGNED: Collectively, low Lund-Mackay and CT scores of the ethmoid and frontal sinuses are significantly associated with healing of OMS treated by tooth extraction alone. The sinus CT score can help identify a treatment strategy for OMS.
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