Association of Comorbid Asthma and the Efficacy of Bioabsorbable Steroid-eluting Sinus Stents Implanted After Endoscopic Sinus Surgery in Patients with Chronic Rhinosinusitis with Nasal Polyps

Objective To identify factors affecting the efficacy of steroid-eluting sinus stents implanted after endoscopic sinus surgery(ESS)in patients with chronic rhinosinusitis with nasal polyps(CRSwNP).Methods We performed a post-hoc analysis of a randomized self-controlled clinical trial on post-operative implantation of bioabsorbable steroid-eluting stents in patients with CRSwNP.Univariate logistic regression analysis was conducted to identify which of the following factors affect the response to post-operative stent implantation:sex,serum eosinophil levels,history of prior surgery,endoscopic scores,and comorbid conditions(asthma and allergic rhinitis).The primary outcome was the rate of post-operative intervention on day 30,and the secondary outcome was the rate of polypoid tissue formation(grades 2–3)on days 14,30,and 90.Results A total of 151 patients with CRSwNP were included in the post-hoc analysis.Asthma was identified as the only risk factor for a poor response to steroid-eluting sinus stents on post-operative day 30,with an odds ratio of 23.71(95%CI,2.81,200.16;P=0.004)for the need for post-operative intervention and 19(95%CI,2.20,164.16;P=0.003)for moderate-to-severe polypoid tissue formation.In addition,the asthmatic group showed higher rates of post-operative intervention and polypoid tissue formation than the non-asthmatic group on post-operative day 30.Blood eosinophil levels were not identified as a risk factor for poor outcomes after stent implantation.Conclusion Comorbid asthma,but not blood eosinophil level,impairs the efficacy of steroid-eluting sinus stents in the short term after ESS in patients with CRSwNP.

Editorial Commentary:Association of Comorbid Asthma and the Efficacy of Bioabsorbable Steroid-eluting Sinus Stents Implanted after Endoscopic Sinus Surgery in Patients with Chronic Rhinosinusitis with Nasal Polyps

Chronic rhinosinusitis with nasal polyps(CRSw-NP)is a multifactorial and heterogeneous disorder of the sinonasal mucosa,characterized by a high relapse rate after medical and surgical treatments[1].Endoscopic sinus surgery(ESS)is the preferred treatment for CRSwNP in patients who have failed to respond to medical therapy[2].However,the postoperative complications will impair the recovery of patients,and accompanying post-operative outpatient visits may contribute to patient discomfort[3]Suppressing postoperative mucosa edema and improving mucosa recovery is critical to reducing the disease relapse after ESS.The steroid-eluting sinus stent(SESS)represents a promising emerging therapy for CRSwNP.

Genetically modified pigs:Emerging animal models for hereditary hearing loss

Hereditary hearing loss(HHL),a genetic disorder that impairs auditory function,significantly affects quality of life and incurs substantial economic losses for society.To investigate the underlying causes of HHL and evaluate therapeutic outcomes,appropriate animal models are necessary.Pigs have been extensively used as valuable large animal models in biomedical research.In this review,we highlight the advantages of pig models in terms of ear anatomy,inner ear morphology,and electrophysiological characteristics,as well as recent advancements in the development of distinct genetically modified porcine models of hearing loss.Additionally,we discuss the prospects,challenges,and recommendations regarding the use pig models in HHL research.Overall,this review provides insights and perspectives for future studies on HHL using porcine models.

Recent advances in the application of MXenes for neural tissue engineering and regeneration

Transition metal carbides and nitrides(MXenes)are crystal nanomaterials with a number of surface functional groups such as fluorine,hydroxyl,and oxygen,which can be used as carriers for proteins and drugs.MXenes have excellent biocompatibility,electrical conductivity,surface hydrophilicity,mechanical properties and easy surface modification.However,at present,the stability of most MXenes needs to be improved,and more synthesis methods need to be explored.MXenes are good substrates for nerve cell regeneration and nerve reconstruction,which have broad application prospects in the repair of nervous system injury.Regarding the application of MXenes in neuroscience,mainly at the cellular level,the long-term in vivo biosafety and effects also need to be further explored.This review focuses on the progress of using MXenes in nerve regeneration over the last few years;discussing preparation of MXenes and their biocompatibility with different cells as well as the regulation by MXenes of nerve cell regeneration in two-dimensional and three-dimensional environments in vitro.MXenes have great potential in regulating the proliferation,differentiation,and maturation of nerve cells and in promoting regeneration and recovery after nerve injury.In addition,this review also presents the main challenges during optimization processes,such as the preparation of stable MXenes and long-term in vivo biosafety,and further discusses future directions in neural tissue engineering.

Controlled release of dexamethasone from fibrin sealant for intratympanic administration in inner ear therapy

The aim of the present work was to show the sustainability of fibrin sealant in releasing dexamethasone and adjust the protocol for clinical application of the novel method in the treatment of Meniere’s disease (MD) and sudden sensorineural hearing loss (SSHL).Gelation occurred shortly after mixing dexamethasone-containing fibrinogen with thrombin.Dexamethasone was constantly released for at least 16 d at a stable level after 7d in protocol 1 (low-dose),while it was robustly released within 4 d and slowed afterward until 10 d in protocol 2(high-dose).There were significant differences among the time points in Protocol 2 (p<0.01,ANOVA),and the exponential model with the formula y=15.299*e~(-0.483*t) fits the association.The estimated concentration of dexamethasone released on 7 d in protocol 2 was slightly lower than that observed in protocol 1.The fibrin sealant is capable of constantly releasing dexamethasone with adjustable dynamics.Targeted and minimally invasive administration of the material can be achieved in the clinic by sequential injections of the fluids using a soft-tipped catheter.

Comparative utility of vestibular function tests in patients with peripheral and central vestibular dysfunction

Background: Bithermal caloric irrigation, video head impulse test(vHIT), and rotational testing are commonly used to assess peripheral vestibular function, but the relative clinical utility of each test in differentiating patients with peripheral vestibulopathy is debated.Objectives: To determine whether(1) the combination of two or more vestibular tests enhances diagnostic utility over a single test;(2) abnormal test results on vestibular tests correlate with one another.Methods: Retrospective analysis of data collected from multidisciplinary vestibular clinics at two academic medical centers from 2016 to 2022.Results: 150 patients(54.10 ± 15.09 years, 88 females) were included. No individual test was significantly better at predicting the presence of peripheral vestibular damage(p > 0.05). vHIT test results improved significantly when combined with either the caloric test(p = 0.007) or rotary chair test(p = 0.039). Caloric and rotational testing had high sensitivity(74.65% and 76.06%, respectively) and specificity(83.54% and 78.48%, respectively). vHIT demonstrated excellent specificity(89.87%) but poor sensitivity(47.89%). Caloric, vHIT, and rotary chair tests results did not correlate with one another(p > 0.05).Conclusions: Vestibular function tests have comparable diagnostic utility, yet each offers unique advantages. Caloric and rotational testing may be best suited for screening peripheral damage and vHIT may function ideally as a confirmatory test.

m^(6)A modification of lncRNA in middle ear cholesteatoma

Objective:Middle ear cholesteatoma is a non-tumorous condition that typically leads to hearing loss,bone destruction,and other severe complications.Despite surgery being the primary treatment,the recurrence rate remains high.Therefore,exploring the molecular mechanisms underlying cholesteatoma is crucial for discovering new therapeutic approaches.This study aims to explore the involvement of N6-methyladenosine(m^(6)A)methylation in long non-coding RNAs(lncRNAs)in the biological functions and related pathways of middle ear cholesteatoma.Methods:The m^(6)A modification patterns of lncRNA in middle ear cholesteatoma tissues(n=5)and normal post-auricular skin tissues(n=5)were analyzed using an lncRNA m^(6)A transcriptome microarray.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analyses were conducted to identify potential biological functions and signaling pathways involved in the pathogenesis of middle ear cholesteatoma.Methylated RNA immunoprecipitation(MeRIP)-PCR was used to validate the m^(6)A modifications in cholesteatoma and normal skin tissues.Results:Compared with normal skin tissues,1525 lncRNAs were differentially methylated in middle ear cholesteatoma tissues,with 1048 showing hypermethylation and 477 showing hypomethylation[fold change(FC)≥3 or<1/3,P<0.05].GO enrichment analysis indicated that hypermethylated lncRNAs were involved in protein phosphatase inhibitor activity,neuron-neuron synapse,and regulation ofα-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid(AMPA)receptor activity.Hypomethylated lncRNAs were associated with mRNA methyltransferase activity,secretory granule membrane,and mRNA methylation.KEGG analysis revealed that hypermethylated lncRNAs were mainly associated with 5 pathways:the Hedgehog signaling pathway,viral protein interaction with cytokines and cytokine receptors,mitogen-activated protein kinase(MAPK)signaling pathway,cytokine-cytokine receptor interaction,and adrenergic signaling in cardiomyocytes.Hypomethylated lncRNAs were mainly involved in 4 pathways:Renal cell carcinoma,tumor necrosis factor signaling pathway,transcriptional misregulation in cancer,and cytokine-cytokine receptor interaction.Additionally,MeRIP-PCR confirmed the changes in m^(6)A methylation levels in NR_033339,NR_122111,NR_130744,and NR_026800,consistent with microarray analysis.Real-time PCR also confirmed the significant upregulation of MAPK1 and NF-κB,key genes in the MAPK signaling pathway.Conclusion:This study reveals the m^(6)A modification patterns of lncRNAs in middle ear cholesteatoma,suggests a direction for further research into the role of lncRNA m^(6)A modification in the etiology of cholesteatoma.The findings provide potential therapeutic targets for the treatment of middle ear cholesteatoma.

Molecular mechanism of Xuebijing in treating pyogenic liver abscess complicated with sepsis

BACKGROUND:Xuebijing(XBJ)can alleviate the inflammatory response,improve organ function,and shorten the intensive care unit(ICU)stay in patients with pyogenic liver abscess(PLA)complicated with sepsis,but the molecular mechanisms have not been elucidated.This study aimed to explore the molecular mechanism of XBJ in treating PLA complicated with sepsis using a network pharmacology approach.METHODS:The active ingredients and targets of XBJ were retrieved from the ETCM database.Potential targets related to PLA and sepsis were retrieved from the GeneCards,PharmGKB,DisGeNet,Online Mendelian Inheritance in Man(OMIM),Therapeutic Targets Database(TTD),and DrugBank databases.The targets of PLA complicated with sepsis were mapped to the targets of XBJ to identify potential treatment targets.Protein-protein interaction networks were analyzed using the STRING database.Potential treatment targets were imported into the Metascape platform for Gene Ontology(GO)functional enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analyses.Molecular docking was performed to validate the interactions between active ingredients and core targets.RESULTS:XBJ was found to have 54 potential treatment targets for PLA complicated with sepsis.Interleukin-1β(IL-1β),interleukin-6(IL-6),and tumor necrosis factor(TNF)were identifi ed as core targets.KEGG enrichment analysis revealed important pathways,including the interleukin-17(IL-17)signaling pathway,the TNF signaling pathway,the nuclear factor-kappa B(NF-κB)signaling pathway,and the Toll-like receptor(TLR)signaling pathway.Molecular docking experiments indicated stable binding between XBJ active ingredients and core targets.CONCLUSION:XBJ may exert therapeutic eff ects on PLA complicated with sepsis by modulating signaling pathways,such as the IL-17,TNF,NF-κB,and TLR pathways,and targeting IL-1β,IL-6,and TNF.

Immunomodulation of Proton-activated G Protein-coupled Receptors in Inflammation

Proton-activated G protein-coupled receptors(GPCRs),initially discovered by Ludwig in 2003,are widely distributed in various tissues.These receptors have been found to modulate the immune system in several inflammatory diseases,including inflammatory bowel disease,atopic dermatitis,and asthma.Proton-activated GPCRs belong to the G protein-coupled receptor family and can detect alternations in extracellular pH.This detection triggers downstream signaling pathways within the cells,ultimately influencing the function of immune cells.In this review,we specifically focused on investigating the immune response of proton-activated GPCRs under inflammatory conditions.

Post Thyroidectomy Assessment of Intact Parathyroid Hormone for Early Prediction of Hypocalcaemia

Background: As the half-life of intact parathyroid hormone (iPTH) is very low, it reflects parathyroid insufficiency within minutes to hours after total thyroidectomy. Therefore, iPTH level assessment in the postoperative period can be used to predict the development of hypocalcaemia. The optimal time point to measure serum iPTH is important for the accurate prediction of hypocalcaemia. Aim: This paper aims to evaluate the ability of iPTH as an early predictive marker of hypocalcaemia and determine which time iPTH is more able to predict postoperative hypocalcaemia. Method: This prospective observational study was conducted in the Department of Otolaryngology-Head & Neck Surgery, BSMMU, Dhaka, from July 2020 to December 2021, with 67 patients who underwent total thyroidectomy. iPTH levels were measured on the day before the operation and at 1 hour, 4 hours, and 24 hours after the operation. S.calcium levels were measured on the day before the operation and 1st postoperative day. All the data were compiled and sorted properly and were analyzed statistically. Results: Postoperative hypocalcaemia developed in 18 cases, with an incidence of 26.9%. Pearson correlation showed a significant correlation between postoperative iPTH at 1 hr, 4 h, and 24 hr with 1st postoperative calcium value. The Receiver operating characteristic (ROC) curve was processed for the postoperative iPTH at 1 hr, 4 h, and 24 hr. The sensitivity, specificity, cut-off value, and mean AUC found 93.9%, 94.4%, ≤14.0, 0.988;95.9%, 94.4%, ≤09.5, 0.993 and 91.8%, 94.4%, ≤11.0, 0.993 respectively. Conclusion: iPTH can be used as an early predictor of post-thy-roidectomy hypocalcaemia. 4 hr iPTH showed more sensitivity and specificity for a cut-off value near the laboratory reference range.

The Versatility of Acellular Fetal Bovine Dermal Matrix for Head and Neck Surgical Reconstruction in Children

Objectives: To describe the versatility of acellular fetal bovine dermal matrix as an alternative to human cadaveric allograft for head and neck reconstructive procedures in children. Study Design: Case series with chart review. Methods: A database of pediatric operative procedures was queried for the use of acellular fetal bovine dermal matrix over a 16-month period. Indications for reconstruction were assessed and initial parental and surgeon satisfaction with the product were noted. Results: During the time period of 3/2012 and 7/2013 a total of 8 reconstructive procedures were performed on pediatric patients using acellular fetal bovine dermal matrix. Indications for use varied and included open and transnasal endoscopic repair of encephaloceles and soft tissue reconstructions including lateral pharyngeal wall repair, cleft palate repair, and facial recontouring operations. Acellular fetal bovine dermal matrix had a subjectively increased ease of use as compared to the surgeon’s prior experience with human cadaveric acellular dermis. Every parent vocalized a greater comfort level with the use of a bovine product over the alternative of human cadaveric tissue. The cost of acellular fetal bovine dermal matrix is slightly lower than the cost of human cadaveric acellular dermis. Conclusions: Acellular fetal bovine dermal matrix appears to be an acceptable alternative to human cadaveric acellular dermis for various forms of head and neck soft tissue reconstruction in children. Further prospective studies are warranted to assess for any differences in the long-term efficacy of this product as compared to other forms of allograft reconstruction.

Quality of Life after Functional Endoscopic Sinus Surgery in Patients with Chronic Rhinosinusitis

Chronic Rhinosinusitis (CRS) is a group of disorders characterized by the inflammation of mucosa of the nasal passages and paranasal sinuses. It includes chronic rhinosinusitis with polyps, CRS without polyps and Allergic Fungal Sinusitis (AFS). This debilitating disease causes negative impact on quality of life (QOL) of patients. Functional endoscopic sinus surgery (FESS) is the mainstay of surgical treatment for patients and improves QOL of patients. This subjective assessment of QOL can be measured by disease specific questionnaires. SNOT-22 questionnaire is widely used and validated questionnaire for this purpose. Prospective study was done on 54 patients. Data were collected using SNOT-22 questionnaire and filled in pre-operative period then in post-operative follow-up visits on 1st, 3rd, 6th and 12th months. Paired sample t-test was used to compare pre-operative and post-operative SNOT scores and multivariate generalized linear model was used to estimate regression parameters for SNOT scores in CRS with polyp and AFS in comparison of CRS without polyps. Out of 54 patients, 59.3% were males, mean age was 35.98, 29.6% were in CRS without polyp group, 44.4% and 25.9% were in CRS with polyps and AFS group. Recurrence occurred in 7.4%, revision surgery required in 3.7% while 22.2% had history of asthma. Paired sample t-test showed statistical significant reduction in post-operative SNOT scores. Linear model results showed SNOT scores in CRS with polyp group was significantly reduced. Thus FESS provides significant improvement in QOL of patients in chronic rhinosinusitis.

Microecosystem of ostiomeatal complex and the changes via functional endoscopic sinus surgery

Objective: To study the composition of microecosystem in ostiomeatal complex (OMC) of adults and the changes via functional endoscopic sinus surgery. Methods: 220 adults with chronic sinusitis(20 as control) were classified into pre- and post-operative groups, and categorised according to its type of sinusitis. Swab specimens were taken from three different sites of ostiomeatal complex in each individual, and cultivations and identifications of aerobes, anaerobes and fungi were performed simultaneously. The microecosystem was analysed. Results: Cultured aerobes belonged to 30 species from 13 genera, anaerobes species, and fungi 3 major species, most of which have none or less virulence. The difference of mi-croecological status between type Ⅰ and Ⅱ was not significant (P > 0.05). Aerobic culture rates between preoperative group and control group had significance(P < 0.01);culture rate descended in postoperative group while the difference was not significant compared to preoperative group (P > 0. 05); difference of rate of same aerobic culture from three sites (RSAC) , which reflects the microecological integrity of OMC, between preoperative and control group was significant (P < 0.01), while was not between postoperative group and control one(P > 0. 05). Taking fungi into account, differences among all groups had no significance(P>0.05); anaerobes were rare in all groups. Conclusion: Being a microecosystem under normal condition, ostiomeatal complex is relatively clean and exists as a whole space. Chronic inflammations separate different parts of which from each other with multimicrobial existence.FESS reverses separation of the microecosystem and rebuild it as a whole again, thus promote the recovery.

Endoscopic nasal surgery for mucocele and pyogenic mucocele of turbinate: Three case reports

BACKGROUND Cases of turbinate mucocele or pyogenic mucocele are extremely rare.During nasal endoscopy,turbinate hypertrophy can be detected in patients with turbinate or pyogenic mucocele.However,in many instances,differentiating between turbinate hypertrophy and turbinate mucocele is difficult.Radiological examinations,such as computed tomography(CT)or magnetic resonance imaging(MRI),are essential for the accurate diagnosis of turbinate mucocele.Herein,we report three cases of mucocele or pyogenic mucocele of turbinate,including their clinical presentation,imaging findings,and treatments,to help rhinologists understand this condition better.CASE SUMMARY Three cases of turbinate and pyogenic mucocele were encountered in our hospital.In all patients,nasal obstruction and headache were the most common symptoms,and physical examination revealed hypertrophic turbinates.On CT scan,mucocele appeared as non-enhancing,homogeneous,hypodense,well-defined,rounded,and expansile lesions.Meanwhile,MRI clearly illustrated the cystic nature of the lesion on T2 sequences.Two patients with inferior turbinate mucocele underwent mucocele lining removal,while the patient with pyogenic mucocele underwent endoscopic middle turbinate marsupialization.The patients were followed up on the first,third,sixth month,and 1 year after discharge,and no complaints of headache and nasal congestion were reported during this period.CONCLUSION In conclusion,both CT and MRI are helpful in the diagnosis of turbinate or pyogenic mucocele.Additionally,endoscopic nasal surgery is considered to be the most effective treatment method.

Correlation between Central and Lateral Neck Dissection in Differentiated Thyroid Carcinoma

Objective: To determine the histopathological correlation between central and lateral neck metastasis in differentiated thyroid carcinoma, and its potential therapeutic impact. Although the central neck dissection (CND) is recommended in differentiated thyroid carcinoma, the indication for lateral neck dissection (LND) remains controversial. Design: Retrospective study. Methods and Main Outcome Measures: Pathological analysis of systematic ipsilateral central neck dissection (CND) and LND performed with total thyroidectomy in differentiated thyroid carcinoma was retrospectively reviewed according to “side” and to “patient”. Results: A total of 56 sides (46 patients) were suitable for analysis. Analysis by “side” revealed that CND and LND dissection samples were both negative in 15 cases, both positive in 32, CND was positive and LND was negative for 8 cases and CND was negative and LND was positive in 1 case. The combined presence of positive LND and positive CND was therefore observed in 32/40 “sides” and 26/46 “patients”. Analysis by “side” of the impact of the treatment decision to perform ipsilateral LND only in patients with positive CND and vice versa demonstrated a sensitivity, specificity, and accuracy of 97%, 65%, and 84%, respectively. Conclusions: In most cases, the presence of positive LND was associated with positive ipsilateral CND. The very low prevalence of positive LND in patients with negative CND may justify LND as a second step procedure only in patients with positive CND, except in the case of documented lateral neck metastasis.

Botulinum toxin therapy in ENT.Head and Neck practice

Botulinum toxin (Botox) acts presynatically at thenerve terminals to prevet calcium - dependent release ofacetylcholine, causing temporally paralysis of the target-muscle injected. The effects generally last about 3～6months. The characteristics of Botox can be summarized asthe following: specific attack and reversible effects, whichare efficacious in controlling the symptoms of patients withmovement disorders involving neuronal origins.

A Combination of Endoscopic CO₂Laser Microsurgery and Radiotherapy for Treatment of T2N0M0 Glottic Carcinoma

The aims of this study were to evaluate the results of CO2 laser surgery alone and CO2 laser surgery combined with radiotherapy in patients with T2N0M0 glottic carcinoma. A retrospective analysis was conducted of 35 cases of T2N0M0 glottic carcinoma. Fourteen patients with normal vocal cord mobility were treated with endoscopic CO2 laser surgery alone. The remaining 21 patients were treated with CO2 laser surgery followed by radiotherapy (44 - 70 Gy, including low-dose carboplatin chemoradiotherapy). Main outcome measures were local control, organ preservation, recurrence, 5-year survival, and successful salvage in cases of recurrence. We evaluated the patient’s voice with the psychoacoustics GRBAS scale, maximum phonation time (MPT), and airflow rate (AFR) obtained by aerodynamic tests. Mean follow-up period was 5 years. Among the 35 T2N0M0 patients, 5-year survival and 5-year voice preservation rates were 97% and 89%, respectively. Local recurrence occurred in 7 of these patients (20%);4 of 7 local recurrences were successfully re-treated by laser surgery. Total laryngectomy was necessary for salvage treatment in the remaining 3 patients. The post-treatment voice qualities were judged to be the same or improved over pretreatment qualities. There was little change in MPT and AFR after treatment in non-recurrence patients. CO2 laser microsurgery is an excellent tool for treating selected cases of T2N0M0

An Overview and Comparative Evaluation of Head and Neck Cancer Risk Factors in India and Australia

Aim: An overview and comparative evaluation of head and neck cancer risk factors in India and Australia. Method: In this review we included articles with information on head and neck cancer risk factors and its association based on: smoking tobacco, alcohol, smokeless tobacco, betel nut and areca nut chewing, viral infection like HPV, dental hygiene, diet, family history, socioeconomic status, other heavy metals and systemic conditions. Articles with clinical features, diagnosis, treatment and prognosis were excluded. Results: Head and neck cancer in India has different demographic, risk factors, dietary habits, personal and family history. Oral cancer is more common amongst all head and neck squamous cell cancers in males. This is mainly attributed with consumption of a variety of smokeless tobacco, smoking, alcohol, poverty, illiteracy, cultural, advanced stage at presentation;lack of good treatment infrastructure creates main challenge to India as compared to Australia. Conclusion: The knowledge about risk factors for HNC in public health education for general population supports health promotion and tobacco prevention, which is the main aim of the programs started by the government, as head and neck cancers are potentially preventable.

Endoscopic sinus surgery plays an essential role in systematic treatment of odontogenic maxillary sinusitis

Purpose:Odontogenic maxillary sinusitis(OMS)is frequently encountered in otorhinolaryngologists'clinical practice.Endoscopic sinus surgery(ESS)instead of surgeries in intraoral approach has been widely applied among OMS.However appropriate treatments due to the causes of the OMS as well as the outcome have been less investigated,meanwhile the inherent incidence of OMS may be still on the rise.This study was designed to conclude our systematic treatment within follow-up examination.Materials and methods:In this retrospective study patients confirmed diagnosis of OMS who had systematic follow-up examinations were analyzed.Medical histories of otorhinolaryngologists and dentists were reviewed as well as preoperative examination protocols.Result:Consecutive 29 Patients(10 women,19 men)were included.41.4%(12/29)patients experienced facial pain as the most frequent symptom.69.0%(20/29)patients admitted firstly to otorhinolaryngologists,13 patients were treated with surgical procedure while 7 patients lacking of surgical indication were transferred to dentists.31.0%(9/29)patients were advised by dentist for being suspected of maxillary sinusitis,including 7 patients suffered from sinonasal complications of dental treatment(SCDT).Conventional dental treatment(root planning,root end surgery,extraction)was the most common cause.Follow up for a mean of 15.1(ranges from 6 to 96)months showed 29 patients maintaining open maxillary ostium on endoscopic examination or improving on CT except recurrence in one patient with SCDT.Conclusion:Patients should be inspected by dentists carefully when the patient has symptoms rather than sinusitis-like symptoms,the possibility of OMS should always be considered.Dental examination can help to determine whether a maxillary sinusitis has a dental origin,periodontitis and odontogenic radicular cysts still are the most common causes comparing with iatrogenic factors.Patients treated with ESS showed better tolerance and fewer postsurgical complications.Not all patients with OMS including SDCT need definitely surgery whether ESS or intraoral approach,removing dental focus followed with antibiotics would be optimistic choice.