Department of Otorhinolaryngology, Juntendo University Faculty of Medicine, Tokyo, Japan.
Department of Human Pathology, Juntendo University Faculty of Medicine, Tokyo, Japan.
J Craniofac Surg. 2024 Jun 1;35(4):e387-e389. doi: 10.1097/SCS.0000000000010139. Epub 2024 May 1.
Accidentally extruded root canal filler within the sinuses may induce maxillary sinusitis with fungal mass. The authors describe 2 cases of gutta-percha-induced fungal masses in the left maxillary sinus of 2 women. The lesions were evaluated preoperatively using both computed tomography and magnetic resonance imaging, providing comprehensive insights into the condition. In one patient, the lesion was located such that it could be resected through the middle meatal antrostomy alone. However, the second patient presented with an anteroinferiorly situated lesion that necessitated not only a transnasal approach but also an endoscopic modified medial maxillectomy. Both patients recovered uneventfully after surgery. This case series is the first published report of 2 cases of gutta-percha-induced maxillary sinus fungal masses, with their imaging findings, successfully treated through different routes through transnasal endoscopic surgery. These reports highlight the need for a collaborative approach between dental practitioners and otolaryngologists. In addition to the patient's wishes, surgical interventions must consider the unique characteristics of each case and the potential for collaboration across different medical specialties.
意外挤出的根管填充物进入鼻窦内可能会引起上颌窦真菌性肿块。作者描述了 2 例女性左上颌窦内发生的牙胶诱导性真菌性肿块。病变在术前使用计算机断层扫描和磁共振成像进行了评估,全面了解了病情。在 1 例患者中,病变位置使得可以仅通过中鼻道切开术进行切除。然而,第 2 例患者的病变位于前下侧,不仅需要经鼻内镜入路,还需要进行内镜下改良经内侧上颌窦切除术。术后 2 例患者均恢复顺利。这一系列病例是首次发表的 2 例牙胶诱导性上颌窦真菌性肿块的报道,其影像学表现通过经鼻内镜手术的不同入路成功治疗。这些报告强调了牙科医生和耳鼻喉科医生之间需要协作。除了患者的意愿外,手术干预还必须考虑到每个病例的独特特征,以及不同医学专业之间合作的潜力。