Work

Role of the Lund–Mackay Score in Determining Surgical Indication in Odontogenic Chronic Rhinosinusitis

Year: 2026

Type: article

Abstract: Computed tomography (CT) of the paranasal sinuses is essential in diagnosing odontogenic chronic rhinosinusitis. Treatment primarily targets the dental focus, with endoscopic sinus surgery (ESS) indicated when necessary. Assessing CT findings using the Lund–Mackay score (LMS) may guide therapeutic decisions. This study retrospectively compared LMS, dental pathology type, and reported symptoms with treatment choices in patients treated for odontogenic chronic rhinosinusitis between 2012 and 2022 at a tertiary otorhinolaryngology center. From 2067 chronic rhinosinusitis patients, 61 had an odontogenic cause. LMS was determined in 57 patients and correlated with treatment strategy. Dental pathology subtypes and presenting symptoms were also analyzed. A control group of 25 patients with localized, non-odontogenic chronic rhinosinusitis was included. Fifteen patients not undergoing ESS had lower LMS values (median 1), while 42 surgical patients had higher scores (median 6). Periapical pathology (47.4%) and oroantral fistula (26.3%) were the most common causes. Nasal discharge and pain were the most frequent symptoms. Neither dental pathology type nor symptoms significantly influenced treatment decisions.The extent of CT-detected pathology, reflected by LMS, can serve as a key criterion in determining treatment for odontogenic chronic rhinosinusitis, independent of symptoms or specific dental pathology type.

Source: Sinusitis

DOI: 10.3390/sinusitis10010007

Authors: Krystof Zuska, Jakub Fuksa, Mikuláš Knotek, Michal Sisák, Petr Schalek

Institutions: Charles University, University Hospital Kralovske Vinohrady

Language: English

Topic: Sinusitis and nasal conditions

Subfield: Otorhinolaryngology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,207