Summary
Introduction. Odontogenic sinusitis is an acute or chronic inflammation of the maxillary sinus. Odontogenic sinusitis accounts for 25–40% of all maxillary sinusitis cases and is more common among women and younger individuals. The close anatomical relationship between the maxilla and the upper teeth leads to the migration of dental infections, iatrogenic substances used in endodontic procedures and oral microflora into the maxillary sinus.
Clinical case. A 54-year-old woman developed episodic facial pain, nasal congestion and rhinorrhoea after a tooth extraction and root canal filling procedure. Radiological examination identified a foreign body in the maxillary sinus as a root canal filling material. In the absence of efficacy of conservative treatment of sinusitis symptoms, the patient underwent functional endoscopic surgery of the paranasal sinuses to remove the foreign body and to restore the sinus drainage.
Discussion. Foreign bodies in the maxillary sinus are uncommon and 60% of them are of iatrogenic origin. Dental roots, implants or filling materials disrupt sinus drainage and cause inflammation, leading to the symptoms of unilateral sinusitis: foul-smelling nasal discharge, swollen gums, tooth and facial pain. Early detection by means of computed tomography is essential to avoid intraorbital, intracranial or systemic complications. Surgical removal of the foreign body is essential to prevent recurrence of sinusitis symptoms. Functional endoscopic paranasal sinus surgery is the standard treatment method due to its lower risk of complications, faster tissue healing and shorter hospitalisation period. An inferior antrostomy can be performed to reach foreign bodies in difficult to access sites.
Conclusions. Foreign bodies of iatrogenic origin introduced into the maxillary sinus during dental procedures are important in the aetiopathogenesis of odontogenic sinusitis. Identification of the underlying cause of odontogenic sinusitis is important to ensure the success of surgical treatment and to prevent the recurrence of symptoms.
