Keywords
perforation of maxillary sinus
complications
treatment
How to Cite
Abstract
Aiming on evaluation of results of different variants and tactics in treatment of odontogenic maxillary sinusitis the study of its frequency and structure basing on complex clinical, laboratory, instrumental, radiological tomographic examination, morphohistochemical tests, complex treatment, immediate and delayed results, effects of prophylactic recommendations, monitoring has been performed.
The frequency, structure of odontogenic maxillary sinusitis, statement of main drawback in diagnosis, treatment and prophylaxis have been studied in retrospective group basing on retrospective analysis of 383 archived case histories and monitoring of patients with odontogenic maxillary sinusitis which underwent inpatient treatment in dental department of Kharkiv Regional Clinical Hospital – Center of Emergency Medical Care and Disaster Medicine in 2006–2008, and also 468 patients with odontogenic maxillary sinusitis – prospective group, which underwent in-patient treatment in 2009–2011. The monitoring of delayed complications in patients with odontogenic maxillary sinusitis have been performed basing on answers in 221 questionnaires from 851 sent.
The retrospective and prospective analysis have defined that odontogenic maxillary sinusitis in Kharkiv Region in 2006–2011 is 24% from general quantity of hospitalized patients. Maxillary sinusitis caused by different forms of periodontitis prevail – 28%, including: exacerbation of chronic granulating periodontitis – 54%.
The direct interrelation has been revealed between odontogenic process and the condition of mucous membrane of maxillary sinus. Depending on cause that conditioned the development of odontogenic maxillary sinusitis, terms of development, hyperplastic changes and dysregenerative processes of different severity, decrease of intensity of reaction on на sulphatized glycosaminoglycanes (0.119±0.012 conventional units) and increase of intensity of nonsulphatized glycosaminoglycanes (0.201±0.011 conventional units), more expressed in patients with the duration of inflammatory process more than 6 months.
The performed monitoring allowed to reveal the following: in retrospective group – the character of complications in 26% is repetitive operative invasion, terms of development of them is 44% in first year; the cause of complications in 27% of patients is odontogenic maxillary sinusitis which was caused by different forms of periodontitis; in prospective group the character of complications in 22% is revealed in form of excretions from nose, repetitive operative intervention in this case takes place in 16%, the terms of development of complications is 27% in 1.5 years, the cause of complications most often in 30% is the group of patients in which odontogenic maxillary sinusitis has unknown etiology.
The retrospective analysis of results of treatment of odontogenic maxillary sinusitis has showed that the most often complications develop in patients with odontogenic maxillary sinusitis caused by different forms of periodontitis – 10%, and in case of presence of foreign body in maxillary sinus – 32%.
Further perspectives of research concern the development of stratification principle of evaluation of risk of complication after surgical intervention regarding odontogenic maxillary sinusitis and the probability of relapse.
Keywords: odontogenic maxillary sinusitis, perforation of maxillary sinus, complications, treatment.
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