John R Craig1, David M Poetker2,3, Umut Aksoy3,4, Fabiana Allevi5, Federico Biglioli6, Bruce Y Cha6, Matteo Chiapasco7, Jerome R Lechien8, Ahmad Safadi9, Regimantas Simuntis10, Roderick Tataryn11,12, Tiziano Testori13,14,15, Matthias Troeltzsch16, Saulius Vaitkus17, Hidenori Yokoi18, Giovanni Felisati19, Alberto M Saibene19. 1. Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, Detroit, MI. 2. Department of Otolaryngology- Head and Neck Surgery, Medical College of Wisconsin, Milwaukee, WI. 3. Division of Surgery, Zablocki VAMC, Milwaukee, WI. 4. Department of Endodontics, Faculty of Dentistry, Near East University, Mersin, Turkey. 5. Department of Health Sciences, San Paolo and Carlo Hospital, Maxillofacial Surgery, University of Milan, Milan, Italy. 6. Division of Endodontology, School of Dental Medicine, University of Connecticut, Farmington, CT. 7. Department of Biomedical, Surgical, and Dental Sciences, San Paolo and Carlo Hospital, Oral Surgery Unit, University of Milan, Milan, Italy. 8. Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, Paris Saclay University, Saint-Aubin, France. 9. Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. 10. Department of Oral and Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania. 11. Tataryn Endodontics, Spokane, WA. 12. Department of Endodontics, School of Dentistry, Loma Linda University, Loma Linda, CA. 13. Dental Clinic, Section of Implant Dentistry and Oral Rehabilitation, IRCCS Orthopedic Institute Galeazzi, Milan, Italy. 14. Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy. 15. Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI. 16. Department of Oral and Maxillofacial Surgery, Ludwig Maximilian University of Munich, Munich, Germany. 17. Department of Otolaryngology-Head and Neck Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania. 18. Department of Otolaryngology-Head and Neck Surgery, Kyorin University, Tokyo, Japan. 19. Department of Health Sciences, San Paolo and Carlo Hospital, Otolaryngology Unit, University of Milan, Milan, Italy.
Abstract
BACKGROUND: Odontogenic sinusitis (ODS) is distinct from non-odontogenic rhinosinusitis, and often requires multidisciplinary collaboration between otolaryngologists and dental providers to make the diagnosis. The purpose of this study was to develop international multidisciplinary consensus on diagnosing ODS. METHODS: A modified Delphi method was used to assess for expert consensus on diagnosing bacterial ODS. A multidisciplinary panel of 17 authors with ODS expertise from 8 countries (8 otolaryngologists, 9 dental specialists) was assembled. Each author completed 2 of 3 surveys (2 specialty-specific, and 1 for all authors). Thirty-seven clinical statements were created, focusing on 4 important diagnostic components: suspecting ODS; confirming sinusitis in ODS; confirming different dental pathologies causing ODS; and multidisciplinary collaborative aspects of diagnosing ODS. Target audiences were all otolaryngologists and dental providers. RESULTS: Of the 37 clinical statements, 36 reached consensus or strong consensus, and 1 reached no consensus. Strong consensus was reached that certain clinical and microbiologic features should arouse suspicion for ODS, and that multidisciplinary collaboration between otolaryngologists and dental providers is generally required to diagnose ODS. To diagnose ODS, otolaryngologists should confirm sinusitis mainly based on nasal endoscopic findings of middle meatal purulence, edema, or polyps, and dental providers should confirm dental pathology based on clinical examination and dental imaging. CONCLUSION: Based on multidisciplinary international consensus, diagnosing ODS generally requires otolaryngologists to confirm sinusitis, and dental providers to confirm maxillary odontogenic pathology. Importantly, both dental providers and otolaryngologists should suspect ODS based on certain clinical features, and refer patients to appropriate providers for disease confirmation.
BACKGROUND:Odontogenic sinusitis (ODS) is distinct from non-odontogenic rhinosinusitis, and often requires multidisciplinary collaboration between otolaryngologists and dental providers to make the diagnosis. The purpose of this study was to develop international multidisciplinary consensus on diagnosing ODS. METHODS: A modified Delphi method was used to assess for expert consensus on diagnosing bacterial ODS. A multidisciplinary panel of 17 authors with ODS expertise from 8 countries (8 otolaryngologists, 9 dental specialists) was assembled. Each author completed 2 of 3 surveys (2 specialty-specific, and 1 for all authors). Thirty-seven clinical statements were created, focusing on 4 important diagnostic components: suspecting ODS; confirming sinusitis in ODS; confirming different dental pathologies causing ODS; and multidisciplinary collaborative aspects of diagnosing ODS. Target audiences were all otolaryngologists and dental providers. RESULTS: Of the 37 clinical statements, 36 reached consensus or strong consensus, and 1 reached no consensus. Strong consensus was reached that certain clinical and microbiologic features should arouse suspicion for ODS, and that multidisciplinary collaboration between otolaryngologists and dental providers is generally required to diagnose ODS. To diagnose ODS, otolaryngologists should confirm sinusitis mainly based on nasal endoscopic findings of middle meatal purulence, edema, or polyps, and dental providers should confirm dental pathology based on clinical examination and dental imaging. CONCLUSION: Based on multidisciplinary international consensus, diagnosing ODS generally requires otolaryngologists to confirm sinusitis, and dental providers to confirm maxillary odontogenic pathology. Importantly, both dental providers and otolaryngologists should suspect ODS based on certain clinical features, and refer patients to appropriate providers for disease confirmation.
Authors: Helen Yue-Lai Chan; Cecilia Nim-Chee Chan; Chui-Wah Man; Alice Dik-Wah Chiu; Faith Chun-Fong Liu; Edward Man-Fuk Leung Journal: Int J Environ Res Public Health Date: 2022-01-07 Impact factor: 3.390