KHẢO SÁT ĐẶC ĐIỂM HÌNH ẢNH HỌC VÀ CÁC TỔN THƯƠNG ĐI KÈM Ở NGƯỜI BỆNH VIÊM XOANG DO RĂNG

Abstract

Objective: Odontogenic sinusitis (ODS) is identified as the leading cause of unilateral maxillary sinusitis, accounting for 45-75% of cases; however, it is frequently overlooked or misdiagnosed in clinical practice. This study was conducted to describe the imaging features of ODS using a standardized classification system and to investigate associated lesions. Methods: A retrospective descriptive case series was conducted on 34 patients diagnosed with ODS (with Definite or Potential evidence) at the University Medical Center Ho Chi Minh City, from January 2023 to June 2025. Results: The mean age of the patients was 49.29 ± 14.81 years, with a male-to-female ratio of 1.1:1. The most common clinical findings were purulent rhinorrhea (79.4%), cacosmia (61.8%), and facial pain/pressure (47.1%). Apical periodontitis was the most prevalent etiology (44.1%), followed by iatrogenic causes (32.4%). The first maxillary molar was the most frequently implicated tooth (41.2%). Imaging revealed unilateral sinusitis in 100% of cases. According to the Di Girolamo classification, Class IV (oroantral fistula) was the most frequent (50.0%), followed by Class IIIA (indicative of ventilation dysfunction) (44.1%). The rate of OMC obstruction on CT was 97.1%. The prevalence of imaging findings suggestive of a fungal ball was 17.6%, while the surgically/histopathologically confirmed prevalence was 8.8%. Conclusion: Odontogenic sinusitis in this study primarily manifested on imaging as pathological forms requiring surgical intervention (Class IIIA and IV). Apical periodontitis was the leading etiology, and the co-morbidity with fungal ball was a significant finding. These results emphasize the role of CT in the comprehensive assessment of ODS, thereby guiding multidisciplinary treatment strategies.