| Abstract | Maksilarni sinusitis definira se kao simptomatska upala maksilarnih
paranazalnih sinusa. Odontogena upala sinusa proizlazi iz bolesti zuba tako da se u
mikrobiologiji i patofiziologiji razlikuje od drugih sinusitisa. Incidencija je
odontogenog sinusitisa niska s obzirom na učestalost dentalnih infekcija. Intimni
anatomski odnos gornjih zuba i maksilarnog sinusa potiče razvoj periapikalne ili
parodontne dentalne infekcije u maksilarni sinusitis. On se također može razviti zbog
upalnih cisti, mehaničkih ozljeda sluzice tijekom liječenja korijenskog kanala,
prepunjenja korijenskog kanala endodontskim materijalom, nepravilno postavljenih
dentalnih implantata, perforacije sinusa pri ekstrakciji ili potiskivanju korijena ili
cijelog zuba u sinus. Simptomi na temelju kojih je moguće dijagnosticirati OMS jesu
unilateralna purulentna rinoreja, maksilarna bol, postnazalna sekrecija, unilateralna
nazalna kongestija te glavobolja. Razlike u simptomima OMS-a i drugih vrsta upala
sinusa nisu značajne, ali je bila veća učestalost jednostranih simptoma. Uz anamnezu
i klinički pregled, ortopantomogram, CT i CBCT primjenjuju se u radiološkoj
dijagnostici. Terapija se izvodi na više načina, a podrazumijeva uklanjanje infekcije,
primjenu antibiotika te kiruršku metodu, Caldwell-Lucovu operaciju ili FESS tehniku.
Komplikacije koje mogu nastati zbog OMS-a jesu orbitalni apsces ili endokranijalne
komplikacije, a mogu biti opasne i za život. Od odontogenih lezija, odontogene ciste
nikad neće invadirati u maksilarni sinus, nego će ga svojim rastom i povećanjem
pomicati. Ciste mogu biti upalne, odontogena keratocista i folikularna cista.
Odontogeni tumori u maksili rijetko se javljaju, a slučajevi sa zahvaćenošću
maksilarnog sinusa vrlo su rijetki. Benigni tumori koji se mogu pojaviti jesu
ameloblastom, Pindborgov tumor, Gorlinova cista, odontom, odontoameloblastom,
odontogeni miksom te cementoblastom. Od zloćudnih tumora u literaturi se navode
ameloblastični karcinom i ameloblastični fibrosarkom, ali i maligne promjene
odontogenih cista. |
| Abstract (english) | Maxillary sinusitis is defined as a symptomatic inflammation of maxillary
sinuses. Odontogenic sinusitis develops as a result of tooth disease, therefore
distinguishing its microbiology and pathophysiology from other forms of sinusitis.
The incidence of odontogenic sinusitis is low compared to the incidence of dental
infections. The close anatomic relation of the upper teeth and the maxillary sinus
allows easy progression of periapical or periodontal infections into maxillary sinusitis.
It can also be caused by inflammed cysts, mechanical injury to the membrane during
root canal treatment, ovefilling the root canal with endodontic material, improper
placement of implants, sinus perforation during tooth extraction, or pushing the root
or a whole tooth into the sinus. The symptoms that indicate odontogenic maxillary
sinusitis are unilateral purulent rhinorrhea, maxillary pain, postnasal secretion,
unilateral nasal congestion, and headache. The difference between symptoms of
odontogenic maxillary sinusitis and other types of sinusitis is not significant, however
there is a higher incidence of unilateral symptoms in odontogenic maxillary sinusitis.
In addition to medical history and clinical examination, orthopantomogram, computed
tomography and cone beam computed tomography are used as part of diagnostic
radiology. Therapy for odontogenic maxillary sinusitis is multifaceted and it includes
the elimination of the infection, antibiotics, surgical methods, Caldwell-Luc
antrostomy, and functional endoscopic sinus surgery. Complications that may ensue
due to odontogenic maxillary sinusitis are orbital abscesses or endocranial complications, which can be dangerous and life-threatening. A cyst coming from odontogenic lesions will never invade a maxillary sinus; however it may push on the sinus through its formation and enlargement. Cysts can be classified as inflammatory, odontogenic keratocysts, and follicular cysts. Odontogenic tumors in maxilla are generally rare, and cases involving maxillary sinuses are very rare. Among the benign tumors that may occur are ameloblastomas, Pindborg tumor, Gorlin cyst, odontoma,
odontoameloblastoma, odontogenic myxoma, and cementoblastoma. In terms of
malignant tumors, the literature mentions ameloblastic carcinoma and ameloblastic
fibrosarcoma, as well as malignant changes in odontogenic cysts. |
