Impact of combined surgery on reoperation rates in odontogenic sinusitis: a retrospective comparative study

Abstract

Purpose: Odontogenic sinusitis (ODS) is a frequent but underdiagnosed condition requiring multidisciplinary management. This study aims to compare outcomes between single-stage combined surgical treatment by otolaryngology and maxillofacial surgery teams versus non-combined approaches, and to evaluate whether the type of prior treatment influences the need for reintervention or secondary procedures. Methods: We conducted a retrospective observational study including 96 patients with ODS surgically treated between January 2019 and December 2024. Patients were categorized according to etiology and surgical strategy (combined vs. non-combined). Additionally, we analyzed whether the type of previous treatment (none, otolaryngology alone, maxillofacial surgery, dentist, or combined) was associated with the need for reoperation or second-stage maxillofacial surgery. Results: Combined surgery significantly reduced reoperation rates (p = 0.003), particularly in periodontic/endodontic infection cases (p = 0.002). No significant differences were observed in the need for second-stage maxillofacial surgery between groups. Reoperation was more frequent among patients initially treated by otolaryngology or maxillofacial surgeons, while those managed first by dentists had significantly lower reoperation rates (p < 0.001). The type of previous treatment was not significantly associated with second-stage maxillofacial surgery. Etiology and patient age did not influence surgical outcomes. Conclusion: Single-stage combined surgery reduces the need for reoperation in ODS. When a staged approach is selected, prioritizing initial dental or maxillofacial management before otolaryngologic intervention appears to yield better outcomes.