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Currently, the iatrogenic mechanism of infection of the maxillary sinus is more common. The share of iatrogenic odontogenic sinusitis in the structure of odontogenic sinusitis is 56 - 90%. Iatrogenic odontogenic sinusitis associated with the removal of the teeth of the upper jaw (oroantral fistulas and preserved roots) accounts for about 50% of all cases of odontogenic sinusitis with iatrogenic etiology. 

Often the cause of the disease are foreign bodies, such as the roots of the teeth, pushed into the maxillary sinus during their removal, filling material, dental implants that migrated into the maxillary sinus. 

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Foreign bodies in the maxillary sinus are a substrate for the growth of fungal microflora and the formation of the fungal body of the maxillary sinus - mycetoma. 

An important factor that determines the occurrence and development of sinusitis is a violation of the drainage function of the maxillary sinus, due to obstruction of the osteomeatal complex, mucosal edema duct inflammation -90

Optimaltreatment tactics for odontogenic sinusitis include surgical removal of the immediate cause of the disease (closure of the perforation (oroantral fistula), removal of a foreign body), remediation of the sinuses and mandatory restoration of normal functioning of the maxillary sinus joint - remediation of complex-58 -bb3b-136bad5cf58d_

 
Ендоскопічна санація гайморових пазух.JP

Endoscopic surgical sinusitis allows minimally traumatic surgical treatment of odontogenic and iatrogenic chronic sinusitis, removal of cysts of the maxillary sinus, polyps, foreign bodies.

 

Minimally invasive endoscopic surgery of the maxillofacial area, including the paranasal sinuses, also reduces to a minimum the length of the patient's stay in the clinic (from 2 to 12 hours after surgery), as well as shorten the postoperative period and recovery period after surgery._cc781905- 5cde-3194-bb3b-136bad5cf58d_

Endoscopic rehabilitation of the maxillary sinuses and osteomeatal complex in Vinnytsia is performed by an experienced maxillofacial surgeon using the latest medical equipment, namely:  

  • endoscopic video camera with Stryker monitor - one of the best modern deep definition and contrast video systems for minimally invasive endoscopic surgery of the maxillofacial area;

  • surgical endoscopes Karl Storz and others.

Minimally invasive endoscopic surgery of the maxillofacial area

Odontogenic sinusitis is a disease characterized by inflammation of the mucous membrane of the maxillary sinus due to pathology of the teeth of the upper jaw or complications of dental manipulations. Odontogenic sinusitis accounts for 10 to 40% of cases of maxillary sinusitis. 

The maxillary sinus is bordered by many important anatomical formations, which causes the risk of complications in the untreated and neglected process: pansinusitis, periostitis, osteomyelitis of the upper jaw, fistula, meningoencephalitis, brain abscess, etc.

The causes of odontogenic sinusitis can be divided into non-iatrogenic and iatrogenic. Non-iatrogenic causes include:

  • acute or recurrence of chronic periodontitis of the upper jaw;

  • purulent radicular cyst;

  • osteomyelitis of the upper jaw;

  • retinated teeth of the upper jaw,

  • polyps and cysts of the maxillary sinus;

  • fracture of the anterior wall of the maxillary sinus, etc.

 

As a result of the operation it was possible to achieve the elimination of sinusitis, restoration of pneumatization of the maxillary sinus and restoration of ostimeatal drainage. 

Clinical case: Iatrogenic stomatogenic bilateral rhinosinusitis. Foreign body of the maxillary sinus.

Clinical case: Iatrogenic odontogenic sinusitis. Oroantral fistula.

Ятрогенний одонтогенний гайморит. До лік

As a result of an unsuccessful (other doctor's) dental operation - resection of the apex of the root of the tooth of the upper jaw, formed

The operation is performed endoscopically, so the patient does not have severe pain and edema in the postoperative period. In addition, the length of stay of the patient in the clinic (from 2 to 10 hours after surgery) and the recovery period after surgery is significantly reduced. 

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Clinical case: Iatrogenic odontogenic sinusitis. Foreign body of the left maxillary sinus.

The patient complained of heaviness and pain in the upper jaw on the left, bad breath from the mouth and nasal cavity, purulent discharge, especially on the back of the pharynx. 

From the anamnesis it became known that 2 years ago the patient had a wisdom tooth removed on the upper jaw, and the patient felt a failure in the depth of the jaw and air from the mouth to the nose and vice versa.

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Treatment: surgical.

Endoscopic rehabilitation of the maxillary sinus under anesthesia. 

Already 1 hour after the operation, the patient noted the disappearance of all symptoms that bothered him for 2 years.

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The patient complained of bilateral rhinosinusitis. 

History: numerous punctures and courses of antibiotic therapy for months. As a result, the patient was sent for traumatic radical sinusitis.

We proposed an endoscopic operation "Removal of a foreign body (in this case a filling material) from the maxillary sinus with restoration of osteomeatal drainage", which almost 100% solves the problem and does not cripple the patient, as a radical sinusitis.

The patient has forgotten about her problems and is happy with life.

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