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This is a useful study looking at how best to manage patients with odontogenic sinusitis and if FESS can be safely avoided. The authors treated patients by removing the odontogenic cause of the rhinosinusitis by extracting the offending tooth and then providing antibiotics. Of 96 patients, 74 recovered without any further treatment (77%) although the remaining 22.9% of patients required further surgical treatment for persistent symptoms. This is very useful to see, as some studies advocate surgical sinus treatment as the first line, and perhaps it can be avoided in the majority of patients. Interestingly the best predictor of full recovery is the disappearance of malodour and this was true when assessed at two weeks, three months and six months. Therefore conversely persistence of malodour two weeks after elimination of odontogenic cause is the strongest indication for surgical sinus treatment. This is useful information for the management of this specific patient group. 

Chronic Odontogenic Rhinosinusitis: Optimization of Surgical Treatment Indications.
Simuntis R, Kubilius R, Tušas P, et al.
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Joanna Stephens

United Lincolnshire Hospitals NHS Trust, UK.

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