Transantral ethmoid-frontal-sphenoidectomy in the odontogenic polysinusitis treatment.

Aims: The odontogenic cause of maxillary inflammation, due to well-know anatomical and functional correlations often reachs to the ethmoid in first, then to the other paranasal sinusal cavities (sphenoidal and also frontal). The classical Caldwell-Luc procedure, universally utilized in the odontogenic maxillary sinusitis, is unable to resolve this inflammatory pathology. It is proposed to use od transantral ethmoid-frontal-sphenoidectomy. They point out the role of the diagnostic methodologies (“high-resolution” CT with digital densitometric analysis and MR imaging) and of the disposable microsurgical instruments that at present allow him the best safety to prevent the minor and major (endocranic, vascular and nervous) complications and also the best confidence in order to the results of the phlogistic foci extirpation and their persistence in the time. Subject: The experience of the unit concerns 35 cases of odontogenic polysinusitis that comprehend: 19 wide periapex inflammation of the upper premolars and molars; 9 oro-antral communications; 3 penetration of dental filling matherial into the maxillary sinus; 4 purulent parasinusal odontogenic cysts. Results: The unit undeline: a) the absence od complications in this treated group; b) the effectiveness of this surgical procedure expecially in the serious oro-antral communications complicated by polysinusal inflammation; c) lastly, the absence of relapses in a 10 years follow-up. Conclusions: The unit cosider the transantral ethmoid-frontal-sphenodectomy the better surgical procedure in the odontogenic wide inflammatory sinus pathology.