Conservative surgical management of a supernumerary tooth in the nasal cavity

2020 ◽  
Vol 13 (7) ◽  
pp. e235718
Author(s):  
Vineet Kumar ◽  
Akhilesh Bhaskar ◽  
Roohi Kapoor ◽  
Pratima Malik
Keyword(s):  
Foreign Body ◽  
Nasal Cavity ◽  
General Anaesthesia ◽  
Surgical Management ◽  
Nasal Congestion ◽  
Surgical Removal ◽  
Supernumerary Tooth ◽  
Ectopic Tooth ◽  
Foreign Body Obstruction ◽  
The Right

A 9-year-old girl presented with a foreign body obstruction inside her nose. The condition led to pain and nasal congestion. CT showed the presence of a radiopaque mass similar to a tooth in the right nasal cavity. Diagnosis of a supernumerary intranasal tooth was made and extraction was performed under general anaesthesia. An ectopic tooth in the nasal cavity is rare and surgical removal is recommended to eliminate the symptoms.

An unusual foreign body in the nostril

2012 ◽  
Vol 126 (9) ◽  
pp. 952-954 ◽  
Author(s):  
K Nathan ◽  
V Nagala ◽  
S Farhat ◽  
A Shah
Keyword(s):  
Foreign Body ◽  
Nasal Cavity ◽  
General Anaesthesia ◽  
Genetic Factors ◽  
Unusual Case ◽  
Lateral Cephalogram ◽  
Unusual Foreign Body ◽  
Nasal Symptoms ◽  
The Right

AbstractBackground:Intranasal teeth are uncommon. Causes include trauma, infection, anatomical malformations and genetic factors. They present mainly in children, and many are asymptomatic.Methods:This report describes the finding of a tooth that had been displaced into the nasal cavity in a six-year-old girl. The history, clinical examination, findings and operative treatment are described.Results:The child presented with nasal symptoms. Examination revealed a tooth in the right nasal cavity, confirmed by a lateral cephalogram radiograph. It was extracted under general anaesthesia. At follow up, the child was asymptomatic.Conclusion:This is an unusual case of a child presenting with an intranasal tooth and nasal symptoms following trauma a number of years earlier. The child underwent extraction of the tooth, and recovered well without any complications.

The Diagnosis and Surgical Management of Intracardiac Quill Foreign Body in a Dog

2016 ◽  
Vol 52 (1) ◽  
pp. 73-76 ◽  
Author(s):  
Daniel Joseph Santiago Nucci ◽  
Julius Liptak
Keyword(s):  
Computed Tomography ◽  
Foreign Body ◽  
Right Ventricle ◽  
Surgical Management ◽  
Foreign Bodies ◽  
Cardiac Injury ◽  
Median Sternotomy ◽  
Good Prognosis ◽  
Bilateral Pneumothorax ◽  
The Right

A dog was referred to Alta Vista Animal Hospital with a porcupine quill penetrating the right ventricle. The presenting complaint was tachypnea and dyspnea secondary to bilateral pneumothorax. Computed tomography revealed bilateral pneumothorax without evidence of quills. A median sternotomy was performed and the quill was removed. The dog recovered uneventfully. Quill injuries are common in dogs; however, intracardiac quill migration is rare. Dogs without evidence of severe cardiac injury secondary to intracardiac foreign bodies may have a good prognosis.

scholarly journals Ekstraksi Benda Asing pada Kavum Nasi Melalui Bronkoskopi

2018 ◽  
Vol 4 (2) ◽  
pp. 45
Author(s):  
Isnu Pradjoko ◽  
Chandra Jaya
Keyword(s):  
Foreign Body ◽  
Nasal Cavity ◽  
Upper Airway ◽  
The United States ◽  
Foreign Body Aspiration ◽  
Lower Airway ◽  
X Ray ◽  
Tracheobronchial Foreign Body ◽  
Chest X Ray ◽  
The Right

Background: Aspiration of a tracheobronchial foreign body is a serious and fatal event. Progress in terms of prevention, first aid, and endoscopic technology, caused a decline of almost 20% of deaths from foreign body aspiration that occurred in the United States. Statistically, the percentage of foreign body aspirations based on their respective location is: 5% hypopharynx, 12% larynx-trachea, and 83% bronchus. Most cases of foreign body aspiration occur in children aged <15 years old; about 75% of foreign body aspirations occur in children aged 1-3 years. The female-to-male ratio is 1.4:1. Case: A 11-year-old boy swallowed needles while playing flashlight about 2 hours before coming to Pulmonary Emergency Room of Dr. Soetomo General Hospital. Discussion: Chest X-ray examination found a shadow of metal density projected in the right lung. Fiber optic bronchoscopy (FOB) was performed for diagnostic and therapeutic indication to see the presence of a foreign body in the airway and remove the foreign body, but failed. When the needle was extracted, the patient coughed that the needle bounces to the supramaxilla area. FOB with nasal cavity approach successfully extracted the corpus alienum. Conclusion: Corpus alienum of airway sometimes is difficult to extract. FOB with nasal cavity approach can be done to manage corpus alienum in the upper airway that moved from lower airway when FOB was performed.

scholarly journals Inverted Papilloma of Nasal Septum

2012 ◽  
Vol 27 (2) ◽  
pp. 39-40
Author(s):  
Min Han Kong ◽  
Bee See Goh
Keyword(s):  
Nasal Cavity ◽  
Endoscopic Resection ◽  
Nasal Septum ◽  
Surgical Techniques ◽  
Inverted Papilloma ◽  
Surgical Removal ◽  
Lateral Nasal Wall ◽  
Endoscopic View ◽  
The Right

Dear Editor,   Papillomas are primary benign epithelial neoplasms producing finger–like projections that typically cover fibrous stalks.1 The term Inverted Papilloma (IP) describes the endophytic projection of epithelium into the stroma. Also known as Schneiderian papillomas, IPs predominantly affect males in the 6th decade.2 They usually arise from the lateral nasal wall and seldom involve the frontal or sphenoid sinuses.2 The frequency of IP on the nasal septum is even less.3 We report a case of IP of the nasal septum and the role of endoscopic resection of the IP without any sign of recurrence.   CASE REPORT A 52-year-old man who was a chronic smoker and worked as a cook presented with a 1-year history of progressively worsening unilateral nasal blockage and hyposmia. Rigid nasoendoscopy revealed a reddish grape-like mass filling the right nasal cavity. The mass extended posteriorly to the posterior nasal space and crossed to the left side and had a broad-based attachment to the posterosuperior part of the nasal septum. Computed tomography (CT) scan showed a heterogeneously-enhanced soft tissue density mass in the right nasal cavity and a soft tissue density in the right ethmoid and sphenoid sinus most likely representing retained secretions. The patient underwent endoscopic excision of the mass using Integrated Power Console (IPC®) system coupled to Straightshot® M4 microdebrider (Medtronic, Minneapolis MN, USA) under general anaesthesia. After induction, each nostril was packed with five rayon neuro-patties (Ray-cot®, American Surgical Company, Lynn MA, USA) soaked with 2mls cocaine 10%, 2mls adrenaline 1:1000 and 6mls of water, carefully placed along the septum, floor and turbinate region. This method reduces the bleeding significantly and prevents blood from impairing the endoscopic view. During the operation, a septal perforation was found at the origin of the mass. No further removal of nasal septum was performed. Histopathological examination (HPE) confirmed the diagnosis of Inverted Papilloma. He has been under our follow-up for the past 5 years and remains well and symptom-free with no evidence of recurrence detected on endoscopic examination.   DISCUSSION Inverted Papilloma (IP) poses many clinical, pathological and even management challenges. There are various surgical techniques advocated for treating IP. Radical transfacial approaches like lateral rhinotomy, minimally invasive endoscopic techniques and even midfacial degloving procedures are among some of the surgical techniques  advocated.4 Most authors agree that complete surgical removal is the hallmark in treating IP.1, 2, 4, 5 Traditionally, en bloc excision of the lateral nasal wall via lateral rhinotomy approach is the standard surgical option for IP arising from the lateral nasal wall. This approach provides good access to the tumor. Despite achieving complete surgical removal, IP tends to recur.1 Recurrence rates of IP when treated surgically are as high as 71%.2 Persistent disease is unacceptable especially with the possibility of malignant transformation.1, 2 It is reported that malignancy in IP is particularly high at 10 to 15%.1                With regard IP of the  nasal septum, Lawson et al. in 1995 reported 5 of 112 IP patients (4%) with isolated septal lesions that were treated by septectomy.6 Our patient underwent transnasal endoscopic resection of the tumor without further need of posterior septectomy. The tumor was removed using a microdebrider. Using the microdebrider for septal surgery usually involves a lateral (PNS and nasal cavity) to medial (septum) process, and posterior inferior to anterior superior shaving technique, also minimizes blood from impairing the endoscopic view. Any visible tumor at the margins was also removed. Unlike conventional polypectomy, complete removal of the tumor and sterilization of the margins is the hallmark in treating IP. Removal of IP without sterilization of the margins should be avoided. Sterilization of the margin is not necessarily by microdebrider only;  other authors have reported debulking tumor completely and sterilizing the margins and underlying bone using a diamond burr.5               Transnasal endoscopic surgery avoided aggressive surgery and facial scarring in this patient. We observed no evidence of recurrence on follow up to date using this method. Although this tumor has the ability to destroy bone, tends to recur, and is associated with malignancy, we demonstrated that transnasal endoscopic resection of IP limited to nasal septum may be safely performed without the need for further septectomy. However, we do not advocate this technique in cases of large tumor or when malignancy is suspected. Endoscopic surgery would not adequately visualize the whole tumor and risk recurrence of tumor.2 Larger series and better study design are required to support our observation and establish an acceptable and safe technique indicated for IP on the nasal septum.         

scholarly journals Nasal Cryptococcosis Caused by Cryptococcus gattii in Sheep in Bahia, Northeastern Brazil

2020 ◽  
Vol 48 ◽  
Author(s):  
Alan Greison Costa Macêdo ◽  
Tiago Da Cunha Peixoto ◽  
Vitor Santiago De Carvalho ◽  
Luciano Nakazato ◽  
Iris Daniela Santos De Meneses ◽  
...  
Keyword(s):  
Nasal Cavity ◽  
The State ◽  
Northeastern Brazil ◽  
Surgical Removal ◽  
Nasal Discharge ◽  
Soap Bubble ◽  
Cryptococcus Spp ◽  
The Right ◽  
First Time ◽  
Irregular Mass

Background: Cryptococcosis is a potentially fatal systemic mycosis that can affect several animal species. The disease is caused by the yeast species Cryptococcus neoformans and C. gattii and is usually associated with immunosuppressive diseases or debilitating factors. In Brazil, cryptococcosis in ruminants has been described in several states, but there have been only two instances of infection in sheep. Until the present, cryptococcosis caused by C. gattii has only been reported in goats. The objective of this study was to describe, for the first time, a case of nasal cryptococcosis caused by C. gattiiin a sheep in the state of Bahia.Case: The disease affected a 4-year-old Santa Inês sheep, created in extensive system in the municipality of Ribeira do Pombal, Bahia, Brazil. The animal presented weight loss, with an asymmetric volume increase in the right nasal cavity, accompanied by dyspnea and bloody nasal discharge. Samples of the tumor mass were collected for cytological analysis of yeast structures compatible with Cryptococcus spp. After cytological diagnosis, the sheep was sent to the Livestock Development Center of the Federal University of Bahia. On physical examination, there was a large and firm irregular mass, strongly adhering to the right nasal cavity and causing facial asymmetry. Surgical removal was attempted, but a marked infiltrative character of the lesion was observed, with extensive tissue destruction. Owing to the unfavorable prognosis, euthanasia was carried out followed by necropsy, in which a large irregular mass was observed that almost completely obliterated the right nasal cavity. Resorption of the right nasal bone and the dorsal and middle nasal turbinates was also observed. Fragments of the nasal lesion were collected, fixed in 10% formalin, routinely processed for histopathology, and stained with hematoxylin and eosin (HE) and Mayer's mucicarmine. Samples of this lesion were sent for molecular characterization of the etiologic agent by polymerase chain reaction (PCR). The histopathological evaluation showed hundreds of generally colorless rounded yeasts cells composed of a clear halo, surrounding a slightly basophilic structure, giving the tissue a vacuolated aspect, known as a “soap bubble lesion” There was also intense inflammatory infiltration and extensive areas of necrosis and hemorrhage, which allowed the morphological diagnosis of diffuse granulomatous rhinitis marked with intralesional yeasts compatible with Cryptococcus spp. Additionally, PCR was positive for C. gattii.Discussion: A case of nasal cryptococcosis caused by C. gattii in sheep in the state of Bahia is described for the first time, diagnosed using clinical-epidemiological, cytological, anatomopathological, and molecular data. Airborne infection occurs by inhaling encapsulated spores present in organic matter, such as decomposing vegetables and bird and bat excreta as observed on the farm where the outbreak occurred. It is important to highlight that sheep and goats affected by cryptococcosis can contaminate the environment, and it is prudent to consider animals with the disease as a risk to public health and eliminate them from the herd, given the costs of the few therapeutic options available on the market. It should be noted that in cases of tumor lesions, which are common in cryptococcosis, cytological examination should be recommended, mainly for screening and distinguishing neoplastic and inflammatory lesions. However, anatomopathological and molecular evaluations are essential for the differential diagnosis of other mycotic rhinitis, in particular,  conidiobolomycosis and nasal pythiosis.

scholarly journals Olfactory Neuroblastoma of the Sinonasal Tract with Prominent Orbital Protrusion: A Case Report and Literature Review

2021 ◽  
Author(s):  
Lin Chen ◽  
Jingxin Wang ◽  
Zhigang Yang ◽  
Yingkun Guo
Keyword(s):  
Nasal Cavity ◽  
Nasal Congestion ◽  
Tumor Grade ◽  
Olfactory Neuroblastoma ◽  
Who Grade ◽  
Therapeutic Decisions ◽  
Nasopharyngeal Biopsy ◽  
Chief Complaints ◽  
The Right ◽  
Unilateral Proptosis

AbstractOlfactory neuroblastoma (ONB) is a rare malignant neuroectodermal tumor of the nasal cavity. Olfactory neuroblastoma centered in the posterior right orbit with prominent orbital protrusion is even rare. Grading ONB is extremely important as individualized treatment plans must be formulated according to tumor grade. We report the case of a 67-year-old female who presented with the chief complaints of persistent nasal congestion with intermittent epistaxis and unilateral proptosis over the past five years. Radiological imaging was suggestive of a large heterogeneous mass in the right superior nasal cavity with extensions into the right medial orbit, nasopharynx, the right maxillary sinus, the anterior cranial fossa, right ethmoidal, frontal and bilateral sphenoidal sinuses, as well as into the right frontal lobe. Assessment of the radiologic features revealed the diagnostic possibility of olfactory neuroblastoma. A nasopharyngeal biopsy confirmed an olfactory neuroblastoma. Frontal osteoplastic craniotomy and excision of the intracranial part of the tumor from above and transnasal endoscopic removal of the mass in the nasal cavities, paranasal sinuses and right medial orbit from below was done. Evaluation of histopathological characteristics and immunohistochemical findings revealed a diagnosis of WHO grade IV olfactory neuroblastoma. Because of poor economic condition, the patient did not take adjuvant radiotherapy and chemoradiation and post-operative examination. We report a huge ONB centered in the posterior right orbit with prominent orbital protrusion. Magnetic resonance image and computed tomography are helpful for evaluating the appearance and the extent of ONB, as well as grading this tumor, which may aid therapeutic decisions and improve survival.

scholarly journals Eustachian Tube Foreign Body with Endoscopic-Assisted Surgical Removal

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Phillip R. Purnell ◽  
Adam Bender-Heine ◽  
Habib Zalzal ◽  
Abdul R. Tarabishy ◽  
Adam Cassis
Keyword(s):  
Foreign Body ◽  
Ct Scan ◽  
Surgical Management ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Rare Case ◽  
Foreign Bodies ◽  
Surgical Removal ◽  
Machine Shop ◽  
Endoscopic Assistance

Objectives. Foreign bodies of the external and middle ear are not uncommon; however, foreign bodies in the eustachian tube are rare. Here we describe the presentation, imaging, and endoscopic-assisted surgical management of a case of eustachian tube foreign body. Methods. A 34-year-old male was seen for evaluation of foreign body of the left eustachian tube while working with metal at a machine shop. Imaging and surgical management are highlighted and review of available literature regarding foreign bodies of the eustachian tube is presented. Results. A CT scan revealed a foreign body present approximately 1 cm into the bony eustachian tube. The patient underwent middle ear exploration which required endoscopic assistance to adequately visualize the foreign body. The foreign body was unable to be removed and required the creation of a bony tunnel lateral to the eustachian tube for visualization and access to the foreign body. Conclusions. This report presents a rare case of eustachian tube foreign body. Use of the endoscope during the surgical removal greatly enhanced the ease and safety of removal. This report also highlights the importance of ear protection with any machining and welding work.

scholarly journals Intranasal Eruption of an Impacted Supernumerary - A Case Report

2021 ◽  
Vol 10 (31) ◽  
pp. 2514-2516
Author(s):  
Eman Bin Saleh ◽  
Manju Philip
Keyword(s):  
Nasal Cavity ◽  
Root Resorption ◽  
Incidental Finding ◽  
Maxillary Sinusitis ◽  
Case Reports ◽  
Occurrence Rate ◽  
Surgical Removal ◽  
Team Approach ◽  
Supernumerary Tooth ◽  
Nasal Floor

Supernumeraries erupting in ectopic regions are one of the commonly found anomalies of orofacial region.1 The mesiodens, being located between the maxillary central incisors is the most common supernumerary tooth.2,3 But impacted mesiodens erupting into nasal cavity is a rare finding. We are detailing an instance of an inverted impacted mesiodens in the nasopalatine canal of an adult patient with encroachment on the nasal floor diagnosed as an incidental finding in panoramic radiograph. Intranasal tooth in adults is reported rare in the literature. Although surgical removal is advised generally on diagnosis of impacted mesiodens, we stress the importance of periodic monitoring of such cases which adds significantly to the patient wellbeing, function and aesthetics. There are few published case reports and most of the cases reported in the literature are in children which prompt for immediate removal upon its recognition. A supernumerary tooth that erupts ectopically into the nasal cavity is referred to as an intranasal tooth. Its occurrence rate is low with only 0.1 to 1 % people being affected from the community.4 The aetiology of intranasal tooth stays undefined. Supernumerary teeth may develop from the region of the nasal cavity as a result of a damage caused by an injury, rhinogenic maxillary sinusitis, a dental disease, oral blisters, obstructed path of dental eruption, and disruption of developmental tissue in the palatine gap.4 The potential complications that can arise due to nasal eruption of tooth are perforation of nasal septum, naso-oral fistula and aspergillosis4. The probable dental complications include midline diastema (17.6 %), late eruption of the permanent incisors (38.8 %), axial rotation of the permanent incisors (16.4 %), root resorption of the neighbouring teeth (4.7 %),5 cyst formation, 6 and infection.1 A team approach with inclusion of disciplines in medicine and dentistry is necessary for planning and execution of an appropriate treatment method in order to prevent complications related to inadvertent surgical entry into vital structures.

scholarly journals Foreign Body in the Sphenoid Sinus

2014 ◽  
Vol 29 (2) ◽  
pp. 46-47
Author(s):  
Alvin B. Javierto ◽  
Josefino G. Hernandez ◽  
Rodante A. Roldan
Keyword(s):  
Foreign Body ◽  
Optic Nerve ◽  
Carotid Artery ◽  
Nasal Cavity ◽  
Sphenoid Sinus ◽  
Medical Center ◽  
Penicillin G ◽  
Initial Attempt ◽  
Post Injury ◽  
The Right

Dear Editor, Foreign bodies in the paranasal sinuses are not so common, but are still possible.  The structures most often involved are maxillary and the frontal sinuses.1 In our case, the sphenoid sinus, which is posterior and deep, was involved.  Having a foreign body lodged in the sphenoid sinus, and considering how it got there, put the patient at great risk of possible involvement of the optic nerve and the carotid artery. Accessing the sphenoid sinus and removing the foreign body lodged in it would be a big challenge to any surgeon. We report one such case. Case Report A 22 year old man, was accidentaly shot in the face by a fellow criminology student while playing with a polyvinyl chloride (PVC) handmade gun two weeks prior to admission.  The patient, who was conscious, coherent, and ambulatory at that time, was brought to a local government hospital where facial CT scans revealed a radio-opaque, well rounded foreign body, approximately measuring 1.5 cm x 1. 5 cm in diameter, lodged in the sphenoid sinus. (Figure 1 A, B) He was subsequently admitted on Penicillin G and was eventually discharged. On his fourth post-injury day, he had profuse epistaxis from the right nostril and consulted at the emergency room of our medical center. Anterior nasal packing did not control the bleeding, and was converted to a posterior nasal pack.  A sutured wound with a scab on the left lateral nasal root was also noted. (Figure 2) The rhinology Service consultants advised endoscopic removal of the foreign body under general anesthesia.    Intraoperatively, the nasal cavity was congested, with slight septal deviation to the right and a collapsed postero-superior septal wall.  Behind the postero-superior 3rd segment of the middle meatus, sphenoethmoidal recess was appreciated. On further exploration, a 1.5 cm x 1.5 cm green marble was seen lodged in the sphenoid sinus.  An initial attempt to remove the foreign body using a nasal foreign body extractor failed.   An improvised large metallic paper clip, molded to the shape of a curved foreign body extractor was also unsuccessful.   A cotton pledget tip dipped in cyanoacrylate (super glue) also failed to have the marble attach to it.  Two angulated sharp foreign body extractors insinuated using the four hand technique yet again failed.  The collapsed posterior end of the nasal septum was removed using a cutting forceps for better visualization and access, and on the last attempt, a bent spoon was used to scoop out marble out of the sphenoid sinus was successful.  (Figure 3) Full extraction of the foreign body was achieved by dislodging the marble towards the nasopharynx and into the oral cavity, without compromising the optic nerve and the carotid artery. (Figure 4)   Discussion It is very common to see a foreign body in the nasal cavity or in the external ear canal, but seeing it in unlikely places like the sphenoid sinus is such a surprise. Many factors need to be considered in the decision to extract it.  One factor to consider is the approach to the sphenoid sinus. There are two different approaches to the sphenoid sinus, external and internal. The external, trans-ethmoidal approach involves subperiosteal elevation and ethmoidectomy.2 Internal approaches such as the trans-septal and trans-nasal are less-invasive ways to access the sphenoid sinus. Because of ease in access, minimal damage to surrounding mucosa, and good exposure, the trans-nasal approach was used. Whatever approach the surgeon chooses, it is important to be familiar with the surgical anatomy to prevent unwanted complications. Creativity also played a role in this procedure, and quick thinking was needed, since the foreign body was a round object and extracting it from such a limited space with utmost care, using makeshift instruments, was critically challenging. Alvin B. Javierto, MD Josefino G. Hernandez, MD Rodante A. Roldan, MD Rizal Medical Center Pasig Blvd., Pasig City 1600       Tel: 671-9740 Fax: 671-4216 Email: [email protected]

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