Analysis of retrospective observations and monitoring of complications in patients with odontogenic maxillary sinusitis

Background. Odontogenic maxillary sinusitis (OMS) remains one of the most preva- lent pathologies located at the intersection of dentistry, otorhinolaryngology, and maxillofacial surgery. In recent years, a steady increase in the incidence of OMS has been observed, which is directly linked to the growing frequency of invasive dental procedures, particularly dental implantation, endodontic therapy, sinus floor elevation, and extraction of maxillary teeth. According to various sources, odontogenic etiology accounts for approximately 10–12% of all cases of maxillary sinusitis, with a tendency toward further growth. The disease is characterized by a complex clinical presentation, and delayed or inadequate treatment may result in the development of a wide range of complications. Consequently, research in this area is of both theoretical and practical significance. It aims to optimize diagnostic protocols, enhance interdisciplinary collaboration between dental and ENT specialists, and minimize the risk of complications and recurrence in affected patients. Purpose – to identify and analyze the complications of odontogenic maxillary sinusitis based on a retrospective data review, taking into account the etiology of the disease, treatment methods, and comorbid conditions. Materials and Methods. A retrospective analysis of 485 patients treated between 2020 and 2024 at the Head and Neck Surgery Department of the Regional Hospital was performed. Patients were categorized into five groups based on OMS etiology: odontogenic cysts invading maxillary sinuses, infected cysts causing purulent OMS, OMS caused by periodontitis, OMS due to foreign bodies including fungal infections, and perforative OMS with fistulas. Diagnosis was confirmed using clinical, laboratory, and radiological methods, including CT. Treatment combined surgical intervention with radical maxillary sinusotomy and local tissue closure, along with medication and physiotherapy during rehabilitation. Follow-up utilized validated questionnaires, computer programs for prognosis and treatment prediction («Easy Sinus»), and individual patient medical cards. Statistical analysis employed parametric tests, Pearson correlation, and significance set at p=0.05. Results. The majority of OMS cases (42.2%) were associated with periodontitis complications. Other groups included cystic invasion (24%), infected cysts (17%), perforative sinusitis with fistulas (11%), and foreign body-induced OMS (6%). OMS predominantly affected working-age adults. The first molar of the upper jaw was the most frequent infection source. Microbiological studies revealed a diverse pathogenic flora dominated by anaerobes and aerobes, often in mixed infections. Complications were noted in 12.1% of cases, with reoperations required in 1.9%. The data highlight the importance of a multifactorial approach, thorough diagnostic algorithms, and long-term monitoring considering prognostic factors and comorbidities. Conclusions. The retrospective data analysis confirms the informativeness of the proposed methods for examination, prediction, and monitoring of complications in the treatment of patients with odontogenic maxillary sinusitis (OMS). The risk of complications increases due to unrecognized or incorrectly verified odontogenic causes (e.g., apical root resection without removal of the infectious lesion.), non-radical surgical interventions, the multifactorial nature of the disease, and comorbidities. Traumatic surgical procedures and inadequate medication therapy pose a particular.