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Background: Odontogenic sinus disease require optimal management that involves definitive treatment of the underlying dental pathology. Further endodontic management with root canal, dental extraction, or apicoectomy. So, endoscopic sinus surgery (ESS) is recommended for patients who fail initial medical and/or dental treatment. However, the optimal timing for ESS is still unclear in literatures. Objective: The aim of this study is to find the optimal time for ESS in odontogenic sinusitis (ODS) patients after the failure of the primary medical treatment. Patients and Methods: This study was conducted on 25 patients with ODS: 14 males and 11 females. After the failure of primary medical treatment, these patients had preferred and undergone ESS. Another 21 patients who had dental intervention were used for comparison (12 females and 9 males). Assessment of the outcome was performed by SNOT-22 questionnaire to all patients. Results: The patients improved as there is a decrease in SNOT-22 score from 38.75 ± 9.56 to 15.7 ± 18.12 in ESS group (p =0.000), more than dental group that decreased from 37.93 ± 11.3 to 28.42 ± 21.7 (p= 0.039). It was observed that the SNOT-22 score increased as the time of intervention increased, so it is advised to start ESS as early as possible to have a successful surgery. Conclusion: An early ESS of ODS is a clue for a fast and successful treatment outcome. So, it is recommended that primary ESS is first to be performed, particularly in patients sufferings severe unresolved sinusitis, followed by dental treatment.

ENDOSCOPIC SINUS SURGERY DECISION AND TIMING FOR ENDODONTIC ORIGIN SINUSITIS AFTER FAILURE OF PRIMARY MEDICAL TREATMENT