Unusual Case of Sinusitis Related to Ectopic Teeth in the Maxillary Sinus Roof/Orbital Floor: A Report

Abstract

This article presents a case report of an adult patient with chronic sinusitis related to the presence of two erupted ectopic teeth located atypically in the maxillary sinus roof/orbital floor after a long latency period associated with childhood facial trauma. This article aims to show the treatment of chronic sinusitis of odontogenic origin by surgical removal of ectopic teeth in an unusual position by direct visualization. This case report discusses the signs and symptoms of chronic sinusitis linked to the presence of ectopic elements and associated with an inflammatory cyst, the choice of complementary tests for diagnosis and surgical treatment through the Caldwell-Luc procedure. After a 2-year follow-up period, the patient presently shows clinical improvement, thus demonstrating the success of the chosen treatment.

Digital design of functional surgery for odontogenic cyst intruding into maxillary sinus

“…Classical Caldwell-Luc, in which the antral lining has been completely removed, could be detrimental to the sinus physiology because the mucociliary lining is replaced with a nonfunctional mucosa, with changes of the bony structures. 2 , 13 There has also been an agreement that the sinus membrane will recover once a proper ventilation is restored. 14 Consequently, preserving the sinus mucosa in place is very important, and together with the computer-assisted pre-surgical design, it can lead to less operation time, less blood loss and less trauma.…”

“…Maxillary sinus is vulnerable to be invaded by odontogenic cystic lesions owing to the anatomical relation to the upper alveolar bone. 1 , 2 These lesions usually intrude into the sinus through the inferior and posterior walls. Management of the maxillary sinus diseases is generally via Caldwell-Luc operation or functional endoscopic surgery.…”

“… 3 In addition, odontogenic cysts often require teeth extraction which may be performed only through an oral approach. 2 Consequently, Caldwell-Luc operation is superior to the endoscopic procedure in cases of odontogenic cysts intruding into the anterolateral or posterior part of the maxillary sinus.…”

Endoscopic removal of ectopic sinonasal teeth: a systematic review

“…Compared to the Caldwell-Luc procedure, the endoscopic removal of maxillary sinus foreign bodies can reduce perioperative morbidity and complications and shorten operating times [14, 15]. Despite widespread applicability of endoscopic techniques, surgeons are still reporting using the trans-antral approach for maxillary sinus ectopic tooth removal [16–18]. This can be combined with endoscopic techniques both as a second portal and to achieve more lateral/anterior access, although this may also be achieved by endoscopic access anterior to the lacrimal duct.…”

Traumatic displacement of teeth into maxillary sinus and the retrieval assisted by computer-assisted navigation

“…[1–3] Traumatic tooth displacement into the maxillary sinus is likely to combine with severe maxillofacial trauma, such displacement is often accompanied with a series of serious complications, such as acute or chronic sinusitis, nasal sinus fistula, pain, and so on. [4–7] Therefore, early retrieval of this “special foreign body” has been recognized by clinicians even if they are asymptomatic. [6,8,9]…”