Potential risk of intracranial infection due to multiple odontogenic sinusitis

We report a clinical case that demonstrates the importance of multiprofessional action in the prevention of intracranial infection in a case of multiple sinusitis originating in the maxillary sinus after to dental procedure. Fifteen days after the extraction of the right upper third molar (tooth 18), a 19-year-old patient presented with symptoms of pulsatile pain at the surgical site, accompanied by oppressive headache, nasal obstruction, fetid mucopurulent rhinorrhea and posterior nasal discharge treated with antibiotics. There was persistence of intermittent headache and sinusitis remained chronic, with tomographic examination compatible with frontal, ethmoidal, sphenoidal and maxillary sinusopathy on the right side, with obliteration of the ipsilateral osteomeatal unit, small calcific foci at the right maxillary floor through areas of soft tissue density, evoking material of dental origin. A sinusotomy and new antibiotic therapy were performed, with a diagnosis of moderate/severe chronic sinusitis, evolving to absence of symptoms. In the presence of symptoms compatible with sinusitis and previous history of dental approach, it is widely necessary to have the attention of both dental surgeon and otolaryngologist to allow an assertive and early diagnosis of odontogenic sinusitis.