Ananthapadmanabhan Saikrishna, Noor Anthony, Sritharan Niranjan
Department of Otolaryngology, Nepean Hospital, Kingswood, NSW 2747, Australia.
Department of Otolaryngology, Westmead Hospital, Westmead, NSW 2145, Australia.
Case Rep Dent. 2022 Sep 12;2022:1730656. doi: 10.1155/2022/1730656. eCollection 2022.
The floor of the maxillary sinus is partly formed by the alveolar process of the maxilla, and this anatomical relationship forms an interface for collaboration between rhinologists, maxillofacial and dental surgeons, and dentists. Odontogenic maxillary sinusitis (ODMS) occurs secondary to infectious processes of the maxillary molar and premolar teeth or following complications from dental procedures. Extruded dental foreign bodies within the sinus can cause chronic mucosal irritation leading to mucociliary dysfunction and sinogenic symptoms. Anteriorly placed foreign bodies are difficult to access via the conventional endoscopic maxillary antrostomy. Endoscopic approaches to access the anterior maxillary sinus involve extended resection of the medial maxillary wall, potentially with the removal of the inferior turbinate and nasolacrimal duct mobilisation. The prelacrimal window approach (PLWA) is a favourable modification that provides excellent visualisation of the maxillary sinus with minimal tissue resection and displacement. We describe the case of an extruded distobuccal 27 tooth root into the anterior maxillary sinus, presenting with acute sinusitis. The patient was successfully managed via a PLWA. This case represents the importance of recognition of ODMS with early referral to otorhinolaryngologists.
上颌窦底部分由上颌骨的牙槽突构成，这种解剖关系形成了鼻科医生、颌面及牙科外科医生和牙医之间合作的界面。牙源性上颌窦炎（ODMS）继发于上颌磨牙和前磨牙的感染过程或牙科手术并发症之后。窦腔内挤出的牙齿异物可导致慢性黏膜刺激，进而引起黏液纤毛功能障碍和鼻窦源性症状。位于前部的异物难以通过传统的内镜上颌窦造口术取出。进入上颌窦前部的内镜手术方法包括扩大切除上颌内侧壁，可能还需切除下鼻甲并移动鼻泪管。泪前窗入路（PLWA）是一种改良方法，能以最小的组织切除和移位实现对上颌窦的良好可视化。我们描述了一例27号牙远中颊根挤入上颌窦前部并伴有急性鼻窦炎的病例。该患者通过PLWA成功治愈。此病例体现了认识ODMS并尽早转诊至耳鼻喉科医生的重要性。
