Terashima Kumiko, Kagoya Ryoji, Tanaka Mariko, Nishijima Hironobu, Kondo Kenji
Department of Otorhinolaryngology and Head and Neck Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, JPN.
Department of Pathology, Graduate School of Medicine, University of Tokyo, Tokyo, JPN.
Cureus. 2024 Sep 26;16(9):e70246. doi: 10.7759/cureus.70246. eCollection 2024 Sep.
Dental materials can stray into the maxillary sinus, causing maxillary sinusitis. We present a case of coexistent fungal rhinosinusitis and actinomycosis caused by gutta-percha points, a core-filling material used for root canal treatment. A 56-year-old man who had undergone root canal treatment with gutta-percha points visited our oral surgery department with complaints of purulent nasal discharge lasting one month. Panoramic radiography confirmed the presence of the foreign body in the left maxillary sinus. As per his wish for tooth preservation, he was referred to our department for the transnasal removal of the material. Nasal endoscopy revealed purulent nasal discharge in the nasal cavity. Computed tomography revealed a soft tissue density lesion filling the left maxillary sinus with a rod-like and spherical radiopaque mass. We performed endoscopic sinus surgery and removed the soft material, in which Candida and actinomycetes were histologically confirmed. Some dental materials containing zinc oxide, such as gutta-percha points, have been reported to cause fungal rhinosinusitis. To our knowledge, there have been no reports of coexisting fungal rhinosinusitis and actinomycosis caused by dental materials extruded into the maxillary sinus. Clinicians should consider the possibility of fungal rhinosinusitis and actinomycosis when removing extruded dental materials.
牙科材料可能误入上颌窦，导致上颌窦炎。我们报告一例由牙胶尖引起的真菌性鼻-鼻窦炎和放线菌病并存的病例，牙胶尖是一种用于根管治疗的根管充填材料。一名曾接受牙胶尖根管治疗的56岁男性因脓性鼻涕持续一个月前来我院口腔外科就诊。全景X线片证实左侧上颌窦内存在异物。鉴于他希望保留牙齿，遂转诊至我科行经鼻取出该材料。鼻内镜检查发现鼻腔内有脓性分泌物。计算机断层扫描显示左侧上颌窦内有软组织密度病变，伴有棒状和球形不透X线团块。我们进行了鼻内镜鼻窦手术，取出了软组织，组织学检查证实其中有念珠菌和放线菌。据报道，一些含氧化锌的牙科材料，如牙胶尖，可引起真菌性鼻-鼻窦炎。据我们所知，尚无因牙科材料挤入上颌窦导致真菌性鼻-鼻窦炎和放线菌病并存的报道。临床医生在取出挤出的牙科材料时应考虑真菌性鼻-鼻窦炎和放线菌病的可能性。
