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左上颌窦顶部异位牙

Ectopic Tooth in the Roof of the Left Maxillary Sinus.

作者信息

Vazquez Isabel, Cebotari Mariana, Pereira Flávia, Coelho Lígia, Burnay Teresa

机构信息

Maxillofacial Surgery Department, Centro Hospitalar Universitário de São João, Porto, PRT.

出版信息

Cureus. 2023 Dec 1;15(12):e49765. doi: 10.7759/cureus.49765. eCollection 2023 Dec.

Abstract

The presence of sinonasal ectopic teeth is a rare entity that is usually asymptomatic. In some cases, the presence of foreign bodies in the maxillary sinus, such as ectopic teeth, can lead to chronic maxillary sinusitis. We report a case of chronic sinusitis because of an ectopic tooth in the roof of the left maxillary sinus in a 50-year-old female who presented with complaints of facial pain in the left maxillary region and purulent nasal discharge. The treatment of ectopic teeth usually consists of the removal of the previous, taking into account its location and possible risks. In this case, the close proximity to the orbit could have led to a greater risk of complications involving the infraorbital bundle. CT scan evaluation is frequently required to identify the exact location and is useful for treatment planning. The traditional surgical approaches to maxillary sinus pathology are transoral Caldwell-Luc approaches or transnasal endoscopic surgery. The method used in this case was the Caldwell-Luc approach. Although more invasive, it allows visualization into the maxillary sinus and superior access for instrumentation of the posterolateral region while permitting manipulation and removal of larger objects. Despite maxillary sinus ectopic teeth being uncommon, it is important for clinicians to become aware and to consider this entity to provide early adequate treatment.

摘要

鼻窦异位牙的存在是一种罕见的情况,通常没有症状。在某些情况下,上颌窦内存在异物,如异位牙,可导致慢性上颌窦炎。我们报告一例50岁女性因左上颌窦顶部异位牙导致慢性鼻窦炎的病例,该患者主诉左上颌区域面部疼痛和脓性鼻涕。异位牙的治疗通常包括根据其位置和可能的风险进行拔除。在这种情况下,由于其与眼眶距离很近,可能导致涉及眶下束的并发症风险更高。通常需要进行CT扫描评估以确定确切位置,这对治疗计划很有用。治疗上颌窦病变的传统手术方法是经口Caldwell-Luc手术或经鼻内镜手术。本病例采用的方法是Caldwell-Luc手术。虽然这种方法创伤性更大,但它可以观察上颌窦内部情况,并能从上方进入后外侧区域进行器械操作,同时便于操作和取出较大的物体。尽管上颌窦异位牙并不常见,但临床医生应提高认识并考虑到这种情况,以便提供早期充分的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5345/10758270/23c931230521/cureus-0015-00000049765-i01.jpg

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