Maxillary Antrolith: A Rare Cause of the Recurrent Sinusitis

Abstract

Introduction. An antrolith is a calcified mass within the maxillary sinus. The origin of the nidus of calcification may be extrinsic (foreign body in sinus) or intrinsic (stagnant mucus and fungal ball). Most antroliths are small and asymptomatic. Larger ones may present as sinusitis with symptoms like pain and discharge. Case Report. We report a case of a 47-year-old lady who presented with heaviness on the left side of the face and loosening of the left 2nd molar tooth since two months. CT scan of the osteomeatal complex and paranasal sinuses showed an opacification of bilateral maxillary sinus and an amorphous area of bone density in the left maxillary sinus. Because of the size of the mass, benign neoplasms were considered in the differential diagnosis. During an endoscopic sinus surgery, it was found to be an antrolith, which was successfully managed by antrostomy and Caldwell-Luc Surgery. Discussion. Antrolith is a rare condition. Rhinoliths are known to invade into the maxillary antrum, but a localised lesion in the antrum is very unusual. A case of an isolated antrolith is presented for its rarity and for differential diagnosis of localised antral disease. Conclusion. Antrolith should be considered as differential diagnosis of unilateral radio-opaque paranasal sinus lesions.

Fechamento De Fístula Bucoantral: Relato De Caso Clínico

“…Esses corpos estranhos podem favorecer a formação de antrólitos que são definidos como calcificações resultantes da deposição de sal mineral em torno de um núcleo dentro da cavidade sinusal. 24 Eles podem ser classificados em endógenos (pela calcificação de sangue, muco, pus, células vermelhas do sangue ou células brancas do sangue) e exógenos (pela calcificação papel, pedaços de vegetais / feijão, rapé, frutas e sementes) 25,26 . Até mesmo materiais de moldagem que entram no interior do seio maxilar podem favorecer a formação de antrolitos, e causar sinutes por corpo estranho 25 .…”

Maxillary sinus diseases – diagnosis and differential diagnosis

“…Smaller antroliths are usually asymptomatic and may be discovered incidentally on routine radiography of the region. Larger ones may present as sinusitis with symptoms like pain and discharge (13,14).…”

“…They can be seen on panoramic, periapical, and Waters' radiographs in addition to computed tomographs (13).…”

“…Antroliths must be included in the differential diagnosis of radiopacities found in or near the maxillary sinus region (13).…”

“…The management of antroliths should include surgical removal of stone by an endoscopic sinus surgery with or without Caldwell-Luc operation, along with appropriate treatment of sinus infection (13).…”