Chronic open lesions of the maxillary sinus

Abstract

Background. Open maxillary sinus lesions are conditions with a high incidence and involve distinct nosological entities: oroantral communication (OAC), oroantral fistula (OAF), and perforative sinusitis. The anatomical complexity of the region and the shared clinical spectrum of these pathologies necessitate interdisciplinary collaboration between dentists and otolaryngologists. Oroantral communication represents the accidental opening of the maxillary sinus during surgical interventions, initially manifesting in the absence of inflammatory phenomena. Data from the specialized literature highlight the relevance of this topic, which remains a subject of debate among specialists. Recent studies indicate that 1/5 of patients with oroantral communication are misdiagnosed, and therapeutic success after primary intervention is reported in only 1/3 of cases. Oroantral communication is considered a rare complication of oral surgery, with studies reporting various incidence rates ranging from 0.31% to 13%, while oroantral fistula presents a rate of 0.2%. Objective of the study. To evaluate the clinical particularities of open sinus lesions based on current data from the specialized literature. Materials and Methods. To achieve the proposed objectives, a synthesis analysis of the relevant medical literature was conducted, selecting clinical studies and review articles published in international databases. Conclusions. The analysis of literature data proposes new diagnostic and therapeutic methods intended to complement and resolve the shortcomings of existing ones. It is essential to distinguish between OAC (primary, acute, non-infected lesion) and OAF (secondary, chronic lesion associated with an inflammatory process). A rigorous preoperative radiographic examination constitutes the determining factor in preventing these complications and ensuring therapeutic success.