Foreign Bodies of Dental Origin in the Maxillary Sinus
WILLARD PARKER, M.D.
Department of Otolaryngology
JOHN K. DUNN, D.D.S.
Department of Dental Surgery
THE following two cases are presented because of their unique nature. They demonstrate the behavior of three foreign bodies of dental origin in the maxillary sinus, each of which originated in the maxillary alveolus. In two instances the objects, which were considerably larger than the natural ostium, were extruded to the outside through the nose. Two of them were associated with secondary oral antral fistulae through tooth sockets that had healed per primum following exodontia procedures.
Case 1. The patient, a 58-year-old woman, was first seen in June 1953. She complained of a chronic clear postnasal discharge of long duration which had always been worse in winter months. Following removal of the upper teeth six months previously, the post-nasal discharge became yellow, and this was accompanied by a sensation of pressure in the right cheek.
Examination revealed excessive clear mucous discharge but no pus. Transillumination of the right antrum was dim. Radiographs of the sinuses showed uniform cloudiness of the right antrum and thickened mucosa in the left antrum. There was a large opaque foreign body within the right antrum and two smaller opaque foreign bodies in the left maxillary alveolus (Fig. 1). Irrigation of the right antrum produced a purulent return.
Dental radiographs indicated that the alveolar foreign bodies were in the left maxillary cuspid and molar areas (Fig. 2). In addition, an area of radiolucency suggestive of inflammatory change was noted in the region of the left maxillary cuspid. Exploratory operation of the left maxillary cuspid.. . .