Prevalência de sinusopatias de origem odontogênica e não odontogênica e variações anatômicas associadas

Abstract

Objective: To verify the prevalence of odontogenic sinusitis and its relationship with possible dental causes, and non-odontogenic sinusitis and associated anatomical variations, on multislice computed tomography (CT) images of patients with indication for sinusitis evaluation. Material and methods: Study characterized as descriptive, cross-sectional and retrospective. The sample consisted of 76 CT with indication for the evaluation of sinusitis, of 860 medical records analyzed, performed at the Regional University Hospital of Campos Gerais (Ponta Grossa, Paraná, Brazil), between September 2017 and September 2019. The evaluation for odontogenic sinusitis was considered when there was thickening of the sinus mucosa larger than 2mm, related to a tooth with some of the following changes: periapical change, periapical change in a tooth with endodontic treatment and clinical failure, severe periodontal disease and foreign body. Non-odontogenic sinusitis was considered when the sinus mucosa thickening was greater than 2mm and not limited to teeth with alterations, where anatomical variations of the nasal cavity, maxillary sinus and related to maxillary sinus drainage were related. When a possible odontogenic source was identified but the sinus mucosa thickening was not limited to the altered tooth region, the sinusitis was classified as undetermined. Results: Odontogenic sinusitis was observed in 23.24% of cases, with periapical alteration being the most prevalent cause, with 70%, followed by periapical alteration in tooth with endodontic treatment and clinical failure (20%), and foreign body (10%). Non-odontogenic sinusitis represented 69.77% of the sample and indeterminate 6.98%, with the most frequent anatomical variation being the middle concha bullosa (37.93%), associated with the nasal cavity, followed by septations (10.34%), associated with the maxillary sinus, and frontal bulla (13.79%), related to maxillary sinus drainage. Examinations with no sinusitis 43.42%. Conclusion: Among the cases of sinusitis indicated for tomographic evaluation, 23.24% had a positive tomographic diagnosis for sinusitis of odontogenic origin, and the presence of periapical alteration in contact with the cortical of the maxillary sinus floor was the most prevalent dental cause. As well as the high percentage of non-odontogenic sinusitis (69.77%) and indeterminate (6.98%), where the middle concha bullosa was the most prevalent anatomical variation.