Transimplant antral lavage as minimally invasive treatment of chronic rhinosinusitis: Preliminary report of 11 consecutive cases

Objective: The present article reports how a dental implant with an internal port dental implant valve approach (DIVA) can be utilized as oroantral port to treat chronic rhinosinusitis (CRS) in a minimally invasive manner. Method and Materials: Eleven patients (age mean 68.1 years) with CRS were subjected to the transimplant lavage technique. For three patients the CRS treatment was performed via previously installed dental implants, and for another eight patients the implantation procedure was combined with the CRS treatment. The moment the implant was fully installed, the sinus membrane was punctured via the implant channel. Upon completion of the pus drainage the sinus was irrigated with normal saline, followed by the injection of a steroid solution (100 mg hydrocortisone). Results: Patients began to report symptomatic improvement from the first day after the first-session procedure. Nine patients had complete relief of most of their symptoms (nasal obstruction/discharge, anosmia/hyposmia) at day 30. The follow- up nasal endoscopy demonstrated no evidence of active sinus disease. All the implants used were found to be well-osseointegrated and still in use for prosthetic purposes. Clinical and radiologic results showed stability and no recurrence in the follow-up period. Conclusion: The dental implant with an internal central port and integral dedicated sealing screw may be used for irrigation, observation, and further treatment of the maxillary sinus in cases of CRS. Keywords: chronic rhinosinusitis, dental implant, lavage, maxillary sinus