Purpose Odontogenic sinusitis and sinonasal complications of dental disease or treatment (SCDDT) represent a heterogeneous group of conditions that often require multidisciplinary care. The present study aims to prospectively validate a classification and treatment protocol for SCDDT patients. Methods One hundred twenty-eight consecutive patients (73 females and 45 males, mean age 52.4 years) affected by SCDDT not responding to dental and medical therapy were classified and surgically treated according to the proposed protocol. The protocol classified patients into three aetiology-based groups (preimplantologic, implantologic, and related to traditional dental diseases and procedures, respectively). The groups were further divided into classes according to the presence of oro-antral communications and/or dislocated dental hardware. Each condition was treated according to the class-related, protocol-defined treatment, by either a transnasal or combined transnasal/transoral approach. All patients were successfully classified according to our protocol. None of the proposed classes were redundant, and no condition fell outside the definitions. Results The surgical treatment protocol proved to be adequate and effective, in that 125 of the 128 patients completely recovered after surgical treatment. Conclusions The term SCDDT and the consequent classification proposed by the authors appear, therefore, to be nosologically correct. Furthermore, the protocol-related proposed treatment appears to be clinically sound, with a success rate nearing 98%.

The outbreak of the COVID-19 pandemic has led to a disruption of surgical care. The aim of this multi-centric, retrospective study was to evaluate the impact of the pandemic on surgical activity for thyroid disease among the Italian Units of Endocrine Surgery. Three phases of the pandemic were identified based on the epidemiological situation and the public measures adopted from the Italian Government (1st phase: from 9th March to 3rd May 2020; 2nd phase: from 4th May to 14th June; 3rd phase: from 15th June to 31st). The patients operated upon during these phases were compared to those who underwent surgery during the same period of the previous year. Overall, 3892 patients from 28 Italian endocrine surgical units were included in the study, 1478 (38%) operated upon during COVID-19 pandemic, and 2414 (62%) during the corresponding period of 2019. The decrease in the number of operations was by 64.8%, 44.7% and 5.1% during the three phases of COVID-19 pandemic, compared to 2019, respectively. During the first and the second phases, the surgical activity was dedicated mainly to oncological patients. No differences in post-operative complications were noted between the two periods. Oncological activity for thyroid cancer was adequately maintained during the COVID-19 pandemic.

SUMMARY The term odontogenic sinusitis (OS) has proved less and less suitable to describe a series of pathological conditions related to dental procedures. We have introduced the term and classification ‘sinonasal complications of dental disease or treatment’ (SCDDT). This study aimed to review our cases and evaluate whether the classification used is applicable to everyday clinical practice. The sample was composed of patients treated for SCDDT from 2002 to 2018 in our Department of Otorhinolaryngology. All presented signs and symptoms of sinusitis and had a recent history of dental disease or treatment. All patients underwent multidisciplinary evaluation, flexible endoscopy and computed tomography (CT) scan. Patients were allocated into three groups depending on the aetiology of the complication, following the classification proposed by Felisati et al. The sample comprised 480 patients (44% men, 56% women) with a mean age of 52.36 years. Of these, 43 patients (9%) belonged to group 1 (class A), 105 (21%) to group 2 (50, 2A; 5, 2B; 27, 2C; 23, 2D) and 332 (70%) to group 3 (119, 3A; 213, 3B). A total of 454 patients (94.5%) had unilateral maxillary opacification, while only 26 cases (5.4%) started as bilateral inflammation. Nine of the latter cases (34.6%) presented a bilateral odontogenic focus, while the other 17 (65.4%) had a history of unilateral dental pathology. The results of this study suggest that SCDDT is a complex entity that needs a careful diagnostic approach based on CT scans and presurgical endoscopy.