Table I.
Optimal management of ODS involves a shared decision-making process between the otolaryngologist, dental provider, and patient, where the benefits and risks of dental treatment and ESS are discussed |
For complicated ODS (orbital or intracranial involvement), patients should undergo ESS, opening all diseased sinuses on CT scan |
For ODS patients who have treatable dental pathology, and have minimal or tolerable sinonasal symptoms, primary dental treatment should be pursued |
Oral antibiotics alone are not appropriate in the management of ODS due to dental pathology amenable to dental treatments |
Once the dental pathology causing ODS has been treated adequately, patients should be followed for at least 1 to 2 months post-treatment to monitor for sinusitis resolution |
Balloon sinus dilation may not be appropriate in patients undergoing sinus surgical intervention for ODS given the degree of inflammation and need for definitive sinus drainage |
For ODS patients who have treatable dental pathology and have failed primary dental treatment, ESS should be pursued |
For ODS patients who have treatable dental pathology, but have significant sinonasal symptoms, primary ESS combined with subsequent dental treatment should be pursued |
For ODS due to maxillary dental implants, primary ESS should be pursued in efforts to preserve the dental implant |
CT: computed tomography; ESS: endoscopic sinus surgery; ODS: odontogenic sinusitis.