Chronic odontogenic rhinosinusitis: optimization of diagnostics and sinus surgical treatment indications

Chronic rhinosinusitis is the inflammation of the mucosal lining of the paranasal sinuses caused mostly by allergies or respiratory infections. The cause of this disease is mainly rhinogenic, but close proximity of the maxillary roots to the sinus floor makes also dental disease a probable cause of chronic rhinosinusitis. This infection may get through the apex of the root, deep periodontal pocket, oroantral fistula, during endodontic treatment or implant surgery. Clinical symptomatology of chronic odontogenic rhinosinusitis is similar to chronic non-odontogenic sinusitis, therefore it is often confused with the latter and treated improperly, what can cause serious complications. Aim of the study To establish most accurate diagnostical radiological method for patients with chronic odontogenic rhinosinusitis, to explore the impact of clinical symptomatology and life quality in chronic odontogenic rhinosinusitis diagnostics, to form clear indications for surgical sinus treatment. Study objectives 1. To explore the clinical efficacy of main radiological methods (CT, OPG, PR) for patients with chronic odontogenic rhinosinusitis. 2. To define the most common clinical symptoms of chronic odonto-genic rhinosinusitis in comparison with chronic non-odontogenic rhinosinusitis. 3. To explore health related life quality in patients with chronic chronic odontogenic rhinosinusitis and to compare it with chronic non-odontogenic rhinosinusitis. 4. To explore the radiological (CT) indications for maxillary sinus surgery in patients with chronic odontogenic rhinosinusitis 5. To explore the changes in clinical symptomatology in patients with chronic odontogenic rhinosinusitis after elimination of dental infection. 6. To form indications for surgical maxillary sinus treatment in patients with chronic odontogenic rhinosinusitis. Novelity of the study Correct identification of dental pathology in CORS is a crucial point in its successful treatment. The properties of main radiological methods that are used for this porpose are widely explored and described in literature [19–21, 35]. On the other hand, another important point is the evaluator of these radiological views, whose work speciality, experience and competence can differ and could have a high impact on the correct diagnosis. In this study, the impact of radiological evaluator for CORS diagnosis is explored for the first time. There is a duobtful difference in clinical symptomatology between CORS and CNRS [22, 25]. On the other hand, the is a lack of studies explor-ing the frequency, severity and impact on HRQL. In thi