Biology

Statistics

Cohort

Genus

Surgery

Exact test

Sinusitis

Sinus (botany)

Botany

Dentistry

Endoscopy

McNemar's test

Mathematics

Internal medicine

Odontogenic

Prospective cohort study

Medicine

Pathology

The Laryngoscope

Objectives Odontogenic sinusitis (ODS) is more common than historically reported, and management recommendations are limited in the literature. Although ODS case series have shown successful outcomes with dental treatment and endoscopic sinus surgery (ESS), no studies have considered the optimal timing of these treatments. The purpose of this study was to analyze times to ODS resolution after primary dental treatment and ESS based on symptom, 22‐item sinonasal outcome test (SNOT‐22), and endoscopic outcomes. Study Design Prospective cohort study. Methods Thirty‐seven symptomatic ODS patients who failed medical management were offered primary dental treatment or ESS. Eleven patients selected primary dental treatment, and 26 patients selected ESS. The following variables were collected prospectively at every office visit before and after dental treatment or ESS: SNOT‐22, presence or absence of cardinal sinusitis symptoms, and presence or absence of middle meatal endoscopy findings (edema, polyps, purulence). Times to resolution of these clinical variables were analyzed with t test, chi‐square test, Fisher exact test, McNemar test, and Kaplan‐Meier survival analysis. Results Patients in the dental treatment and ESS groups showed no significant differences in preoperative sinusitis disease burdens based on symptoms, SNOT‐22, endoscopy, and computed tomography. The ESS group experienced faster and more significant improvement in nearly all symptom, SNOT‐22, and endoscopic outcomes. Conclusions For symptomatic ODS, primary ESS resulted in faster resolution of SNOT‐22, sinusitis symptoms, and endoscopic findings in ODS patients compared with primary dental treatment. ESS can be considered first‐line therapy for symptomatic ODS, followed by dental treatment when necessary. Level of Evidence 2b Laryngoscope , 129:1976–1983, 2019

Optimal timing of endoscopic sinus surgery for odontogenic sinusitis