Abstract
Objective: To successfully manage odontogenic maxillary sinusitis & subclinical oroantral communication post dental implant, using combined endoscopic & Caldwell Luc approach without removing dental implant.
Material and Methods: A 71-year-old lady with dental implants presented with odontogenic maxillary sinusitis + subclinical oroantral communication. Functional Endoscopic Sinus Surgery (FESS) was performed to clear the left-sided sinuses. The maxillary sinus was opened using Caldwell-Luc approach and a 0o endoscope introduced. Titanium screw of implant was thoroughly covered with bone wax. Diagnostic nasal endoscopy was done 3 weeks postoperatively wherein methylene blue dye was instilled into the opening of the maxillary sinus under endoscopic vision. Oral cavity was checked for dye leakage around the implant; there was no dye leakage suggesting the track around the screw had been obliterated successfully. This report was prepared according to CARE checklist.
Results: The patient is doing well 16 months postoperatively with no complaints of any foul-tasting discharge.
Conclusion: We conclude that FESS & Caldwell Luc approach is a successful combined approach to manage odontogenic maxillary sinusitis with oroantral communication and may allow salvage of dental implant, which would have to be removed otherwise.
Keywords
Odontogenic maxillary sinusitis, Caldwell-Luc procedure, Maxillary sinusitis, Odontogenic, Dental implants, Endoscope-assisted surgery, Case report