A study of the prevalence, peculiarities and efficiency of optimization method of complex treatment of odontogenic maxillary sinusitis

Latyushina Larisa Sergeevna, Malysheva Lyudmila Yrievna, Piotrovich Albina Viktorovna, Pavlienko Yulia Viktorovna, Shirshova Natalia Evgenievna

The purpose of the study. To investigate the prevalence, characteristics of clinical course of chronic odontogenic maxillary sinusitis depending on the duration of the disease and evaluation of the efficiency of optimization method of complex treatment of patients with this pathology. Materials and methods. For the period from 2011 to 2019 the study includes several stages: definition of the frequency of occurrence of odontogenic maxillary sinusitis in the absence of clinical symptoms by retrospective analysis of 100 computer tomograms of patients; a prospective survey of 34 patients with an established diagnosis J 32.0, with different duration of the disease; a randomized, short-term, prospective, simple blind, placebo-controlled study to assess the effectiveness of topical immunotherapy in combination with gentle variant of maxillary sinusotomy in 44 patients. Result. The first stage of the research revealed 88% of patients changes in the maxillary sinus, while 84,1% was detected radiological signs of odontogenic etiology of violations.Clinical and microbiological signs of a long-lasting inflammation were revealed in the examined patients with chronic odontogenic maxillary sinusitis with a protracted and continuous course during and by the end of treatment, leading in some cases to an unfavorable outcome of the disease. A positive effect of cycloferon in combination with a sparing maxillary sinusotomy on the clinical course, microbiological and immunological parameters of the postoperative period of chronic odontogenic maxillary sinusitis in patients with a disease period of up to 2 months was revealed. Conclusion. The study allowed us to draw conclusions about the high prevalence of chronic odontogenic maxillary sinusitis, which occurs without clinical symptoms. In all examined patients with chronic odontogenic maxillary sinusitis, the prolonged course of the inflammatory process and adverse outcomes of complex treatment (9.5%), more pronounced when the disease lasted more than 2 months, were determined. Topical immunotherapy with cycloferon in combination with sparing maxillary sinusotomy in patients with a protracted course of chronic odontogenic maxillary sinusitis contributes to a favorable course and outcome of the disease, reduces the number of postoperative complications. A gentle operation technique helps to reduce the rehabilitation period, and a locally administered immunopreparation through the cytokine network activates the effector potential of cells of the inflammatory focus and helps to reduce its total seeding.

Keywords:chronic odontogenic maxillary sinusitis, topical immunotherapy, cycloferon