The Potential of High‐Throughput DNA Sequencing of the Paranasal Sinus Microbiome in Diagnosing Odontogenic Sinusitis

Haider, Asad A; Marino, Michael J.; Yao, William C.; Citardi, Martin J.; Luong, Amber U.

doi:10.1177/0194599819866692

Cited by 12 publications

(8 citation statements)

References 27 publications

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“…Regarding similarities, multiple uncomplicated ODS studies have shown higher rates of certain anaerobic and α-hemolytic streptococcal species in sinus cultures. 6,38-40 These prior studies typically included patients with chronic symptoms, but the current review showed very similar microbiology in patients with acute presentations. Similarly, Brook 41 demonstrated no significant differences in sinus cultures between ODS patients with acute vs chronic symptoms, and therefore ODS microbiology may be stable over time.…”

Section: Discussionmentioning

confidence: 67%

Extrasinus Complications From Odontogenic Sinusitis: A Systematic Review

Craig¹,

Cheema²,

Dunn

et al. 2021

Otolaryngol.--head neck surg.

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Objective Odontogenic sinusitis (ODS) can cause infectious orbital, intracranial, and osseous complications. Diagnosis and management of complicated ODS have not been discussed in recent sinusitis guidelines. The purpose of this systematic review was to describe epidemiological and clinical features, as well as management strategies of complicated ODS. Data Sources PubMed, EMBASE, and Cochrane Library. Review Methods A systematic review was performed to describe various features of complicated ODS. All complicated ODS studies were included in qualitative analysis, but studies were only included in quantitative analysis if they reported specific patient-level data. Results Of 1126 studies identified, 75 studies with 110 complicated ODS cases were included in qualitative analysis, and 47 studies with 62 orbital and intracranial complications were included in quantitative analyses. About 70% of complicated ODS cases were orbital complications. Only 23% of complicated ODS studies were published in otolaryngology journals. Regarding ODS-related orbital and intracranial complications, about 80% occurred in adults, and 75% were male. Complicated ODS occurred most commonly from apical periodontitis of maxillary molars. There were no relationships between sinusitis extent and orbital or intracranial complications. High rates of anaerobic and α-hemolytic streptococcal bacteria were identified in complicated ODS. Management generally included systemic antibiotics covering aerobic and anaerobic bacteria, and surgical interventions were generally performed to address both the complications (orbital and/or intracranial) and possible infectious sources (dentition and sinuses). Conclusion ODS should be considered in all patients with infectious extrasinus complications. Multidisciplinary management between otolaryngologists, dental specialists, ophthalmologists, and neurosurgeons should be considered to optimize outcomes.

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Section: Discussionmentioning

confidence: 67%

Extrasinus Complications From Odontogenic Sinusitis: A Systematic Review

Craig¹,

Cheema²,

Dunn

et al. 2021

Otolaryngol.--head neck surg.

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“…One’s suspicion of ODS would additionally increase if sinus cultures revealed anaerobic or odontogenic bacteria. 6,42–44 The current study suggests that if patients have unilateral maxillary sinus disease on sinus CT and pus in the middle meatus, one should consider an odontogenic source of the infection. Further prospective studies would also be beneficial in determining whether identifying unilateral middle meatal pus alone is predictive of ODS, when no CT is available.…”

Section: Discussionmentioning

confidence: 83%

Predicting Odontogenic Sinusitis in Unilateral Sinus Disease: A Prospective, Multivariate Analysis

Goyal

Ahmad

Turfe

et al. 2020

Am J Rhinol�Allergy

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Background Odontogenic sinusitis (ODS) is a common cause of unilateral sinus disease (USD), but can be challenging to diagnose due to nonspecific clinical presentations, potentially subtle to absent dental pathology on sinus computed tomography (CT), and underrepresentation in the sinusitis literature. Objective Identify sinonasal clinical variables predictive of ODS in patients presenting with unilateral maxillary sinus opacification on sinus CT. Methods A prospective cohort study was conducted on 131 consecutive patients with USD and at least partial or complete maxillary sinus opacification on sinus CT. Patients’ demographics, sinonasal symptoms (anterior and posterior drainage, nasal obstruction, facial pressure, smell loss, and foul smell), 22-item sinonasal outcome test, nasal endoscopy findings, CT findings, and histopathology were collected. Patients’ diagnoses included ODS, chronic rhinosinusitis with or without nasal polyps, and inverted papilloma. Demographic and clinical data were compared between patients with unilateral ODS and non-odontogenic disease using univariate and multivariate analyses. Results Of the 131 USD patients, 65 had ODS and 66 had non-odontogenic disease. The following variables were significantly associated with unilateral ODS on multivariate analysis: middle meatal pus on endoscopy (OR= 17.67, 95% CI-5.69, 54.87; p = 0.001), foul smell (OR= 6.11, 95% CI-1.64, 22.82; p=.007), facial pressure (OR= 3.55, 95% CI-1.25, 10.12; p = 0.018), and any frontal opacification on CT (OR= 5.19, 95% CI-1.68, 16.06; p = 0.004). Any sphenoid opacification on CT was inversely related to ODS (OR = 0.14, 95% CI-0.03, 0.69; p = 0.016). The study was adequately powered. Conclusion With unilateral maxillary sinus disease, the following features were significantly associated with ODS: foul smell, ipsilateral facial pressure, middle meatal pus on endoscopy, and any frontal sinus opacification on sinus CT. Additionally, any sphenoid sinus opacification on CT was inversely related to ODS. Presence or absence of these clinical variables can be used to increase or decrease one’s suspicion of an odontogenic source of sinusitis.

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“…Forty-nine studies reported specific diagnostic criteria 7,10,16–62 and 14 studies did not report any diagnostic criteria (either original or referenced) for OS. 8,11,63–74 It should be noted that four articles 10,21,31,39 were retrospective radiological analyses and provided radiologic diagnostic criteria only.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic Criteria for Odontogenic Sinusitis: A Systematic Review

Allevi

Fadda

Rosso

et al. 2020

Am J Rhinol�Allergy

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Background Odontogenic sinusitis affects a significant proportion of patients with paranasal sinus infections. Nevertheless, no shared diagnostic criteria for this condition have yet been implemented and published studies differ in their definition of the disease. Objective The present systematic review of the literature was undertaken to characterize and analyze the different diagnostic criteria currently employed for odontogenic sinusitis. Methods Systematic searches for studies published between 2009 and 2019 were performed in Medline, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov databases. Search criteria were designed to identify all studies focusing, even partially, on odontogenic sinusitis. Human original studies except single case reports published in the English, French, German, Spanish, or Italian language were included. We removed duplicate abstracts and conducted full-text reads, data extraction, and quality assessment procedures (using the Oxford Centre for Evidence-based Medicine levels of evidence and National Heart Lung and Blood Institute Study Quality Assessment Tools). We reviewed articles for diagnostic criteria, both in terms of definition and etiology identification. Results Among 1,000 unique citations, 63 studies were deemed eligible. Most articles (n = 45) were retrospective case series; a single randomized clinical trial was available. Only 49 studies reported diagnostic criteria, yet relied marginally on published guidelines (n = 10 articles) for identifying sinusitis, often choosing instead to develop their own clinical (n = 15 articles), endoscopic (n = 12 articles), and/or radiologic (n = 30 articles) criteria. For odontogenic focus identification, 14 papers required a multidisciplinary evaluation, 11 papers required a time relationship between dental procedures and sinusitis, 24 papers required oroscopy and/or dental evaluation, and 53 papers required computed tomography. Conclusions Current diagnostic criteria for odontogenic sinusitis are extremely heterogeneous. Establishing shared diagnostic criteria aimed at defining both sinusitis and related odontogenic foci would spur collaboration between investigators and support more comprehensive outcomes evaluations together with a better understanding of treatment options.

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The Potential of High‐Throughput DNA Sequencing of the Paranasal Sinus Microbiome in Diagnosing Odontogenic Sinusitis

Cited by 12 publications

References 27 publications

Extrasinus Complications From Odontogenic Sinusitis: A Systematic Review

Extrasinus Complications From Odontogenic Sinusitis: A Systematic Review

Predicting Odontogenic Sinusitis in Unilateral Sinus Disease: A Prospective, Multivariate Analysis

Diagnostic Criteria for Odontogenic Sinusitis: A Systematic Review

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