Ibrahim Mohamad Ali, El Orra Said, Ramadan Nagham, Lakis Ahmad, Dabbous Mohammed
Medicine, Faculty of Medicine, Saint Joseph University, Beirut, LBN.
Internal Medicine, Beirut Arab University, Beirut, LBN.
Cureus. 2022 Feb 14;14(2):e22204. doi: 10.7759/cureus.22204. eCollection 2022 Feb.
Around 10-20% of sinusitis have a dental etiology. Odontogenic sinusitis is generally caused by periodontitis, peri-implantitis, periapical pathology, or oroantral communication. Ectopic teeth are a rare cause of chronic odontogenic sinusitis. We present a rare case of chronic sinusitis caused by five ectopic teeth. A 39-year-old-female patient presented to our clinic with complaints of facial pain over the left cheek, ipsilateral nasal obstruction, ipsilateral rhinorrhea, and coughing over the last five years. Physical examination revealed a febrile patient. There was an ipsilateral purulent nasal discharge of yellow color. Inspection of the oral cavity revealed the absence of the following maxillary teeth: left first and second premolars, in addition to the left first, second, and third molars. There was also tenderness upon palpation of the left maxillary sinus. Computed tomography (CT) scan of the maxillary sinus revealed hyperdense structures in the left maxillary sinus surrounded by soft tissue, representing the missing premolar and molar teeth. The patient was treated with amoxicillin-clavulanate and corticosteroid, which partially relieved her symptoms. Our case presents an unusual case of chronic sinusitis that was found to be a consequence of five ectopic teeth in the maxillary sinus. A careful physical examination and an appropriate imaging modality are indispensable for the diagnosis of such a rare phenomenon.
约10%-20%的鼻窦炎由牙齿病因引起。牙源性鼻窦炎通常由牙周炎、种植体周围炎、根尖周病变或口腔上颌窦瘘引起。异位牙是慢性牙源性鼻窦炎的罕见病因。我们报告一例由五颗异位牙引起的慢性鼻窦炎罕见病例。一名39岁女性患者因过去五年出现左脸颊面部疼痛、同侧鼻塞、同侧流涕和咳嗽前来我院就诊。体格检查发现患者发热。有同侧黄色脓性鼻分泌物。口腔检查发现上颌以下牙齿缺失：左侧第一和第二前磨牙，以及左侧第一、第二和第三磨牙。左侧上颌窦触诊也有压痛。上颌窦计算机断层扫描（CT）显示左侧上颌窦内有被软组织包绕的高密度结构，代表缺失的前磨牙和磨牙。患者接受阿莫西林-克拉维酸和皮质类固醇治疗，症状部分缓解。我们的病例呈现了一例不寻常的慢性鼻窦炎，发现是上颌窦五颗异位牙所致。仔细的体格检查和合适的影像学检查方法对于诊断这种罕见现象必不可少。
