17 February 2021
: Case report
An Unusual Maxillary Sinus Foreign Body: A Case Report
Unusual clinical course, Diagnostic / therapeutic accidents, Management of emergency care, Educational Purpose (only if useful for a systematic review or synthesis)
Maeidah A. Alrasheed1ABCD, Mohammed S. Alhaddad2ABCDEF*, Nora A. Almuhainy3ADEF, Abrar A. Almohammedali3ADEFDOI: 10.12659/AJCR.928534
Am J Case Rep 2021; 22:e928534
Table 1. Summary of some reported cases of foreign bodies in the maxillary sinus.
Accidental | ||||||||||||
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# | Author (reference) | Age | Type of FB | Mechanism of injury | Route of entry | Presentation | Time gap between procedure, event and diagnosis | Site of FB | Size | Complications | Management | Outcome |
1 | Our case (2020) | 32 | Metallic nail | By a nail gun | Floor of orbital cavity | Left eye bleeding and left cheek parasthenia and numbness | 1 hour | Left Maxillary sinus | 4 cm | Left eye blindness | Caldwell-Luc procedure | Clear maxillary sinus, no evidence of disease after 1 week |
2 | Nataraj et al [] (2015)8 | 25 | Pieces of glass | RTA | Facial wounds | Recurrent headache, Left nasal discharge and post nasal drip, Watering of the left eye | 3 months | Left maxillary sinus | Sinusitis Nasolacrimal duct obstruction | Functional Endo-scopic Sinus Surgery (FESS) and Endo-scopic dacryocystostomy | Free of symptoms after 1 month | |
3 | Gurkan et al [] (2015)6 | 46 | 3 Molar teeth | Congenital | Continuous nasal obstruction, postnasal discharge, and severe facial pain | 3–4 years | Right maxillary sinus | Sinusitis | Caldwell-Luc procedure | Free of symptoms after 1 year | ||
4 | Kim et al [] (2014)9 | 13 | Ballpoint pen | Fall down | Facial wound | Eyelid laceration | Immediately | Right orbit extending into the sphenoid sinus | 8×1 cm | None. | ESS | |
5 | Shao et al [] (2014)17 | 10 | Hand sewing needle | Voluntarily introduced by the patient | Through carious tooth | Primary maxillary right first molar was carious, serious red swelling of the buccal mucosa | 1 day | Right maxillary sinus | 4.2 cm | Sinusitis | Removed with magnetic iron under local anesthesia | Free of symptoms after 2 months |
6 | Agarwal et al [] (2014)7 | 28 | pressure cooker nozzle | Blast injury | Facial wounds | Upper lip split and laceration of upper gingivobuccal sulcus with active bleeding | NA | Maxillary sinus | NA | None | Taken out by manipulation with a long-toothed forceps | NA |
7 | Agarwal et al [] (2014)7 | Bullet | NA | Anterior wall of maxillary sinus | Face laceration | Immediate | Maxillary sinus | NA | NA | Caldwell-Luc procedure | NA | |
8 | Saeed et al [] (2013)28 | 45 | Shell cases | NA | Anterior wall of maxillary sinus | Face laceration | Immediate | Maxillary sinus | NA | NA | Caldwell-Luc procedure | NA |
9 | Şahin et al [] (2012)22 | 24 | Wooden toothpick | Un-known, may be Introduced accidentally or voluntarily by the patient | Oroantral fistula (now healed) after dental extraction | Headache, nasal obstruction, halitosis, chronic purulent rhinorrhea from the left nostril, and postnasal drip | 3 years | Left maxillary sinus | Unilateral chronic sinusitis | Combined endoscopic and Caldwell-Luc procedure | Free of symptoms | |
10 | Batista et al [] (2011)29 | NA | Zinc oxide cement | NA | Oroantral fistula | Postnasal discharge | 1 month | Maxillary sinus | NA | NA | Caldwell-Luc procedure | NA |
11 | Kaushik et al [] (2009)23 | 65 | Cotton ribbon gauze | NA | Oroantral fistula after dental extraction | Regurgitation of fluids into the nose and left maxillary sinus tenderness | 7 months | Left maxillary sinus | NA | NA | Caldwell-Luc procedure | NA |
12 | Prasant et al [] (2009)27 | NA | Match-sticks | NA | Oroantral fistula | Facial swelling | 20 days | Maxillary sinus | NA | NA | Oral exploration in GA followed by Caldwell-Luc for inspection | NA |
13 | Lima et al [] (2008)10 | 49 | Multiple wood and plastic pieces | Voluntarily introduce foreign bodies by the patient | Oroantral fistula | Nasal obstruction, halitosis, cacosmia, purulent rhinorrhea and post nasal drip | Three years | Left Maxillary sinus | NA | Sinusitis | FESS and Caldwell-Luc procedure | Free of symptoms |
14 | Dutta et al [] (2006)24 | NA | Bullet | NA | Floor of Orbital cavity | Orbital injury, face laceration | Immediate | Right maxillary sinus | NA | NA | Caldwell-Luc procedure | NA |
15 | Pang et al [] (2005)25 | 38 | Nail | A piece of metal flew into his right cheek | Facial wound | Laceration on the right cheek, facial pain | 1 week | Right maxillary sinus ostia | NA | NA | Endoscopy | NA |
16 | Pathak et al [] (1999)26 | NA | Metallic foreign body | Blast injury | Floor of Orbital cavity | Orbital injury | 3 weeks | Maxillary sinus | NA | NA | Infraorbital incision-transantral | NA |
NA – not available; FESS – functional endoscopic sinus surgery; MMA – middle meatal antrostomy. | ||||||||||||
Iatrogenic | ||||||||||||
# | Author (reference) | Age | Type of FB | Mechanism of injury | Route of entry | Presentation | Time gap between procedure, event and diagnosis | Site of FB | Size | Complications | Management | Outcome |
1 | Mumtaz et al [) (2020)32 | 72 | Dental implant | During multiple implantations | NA | Right nasal blockage and headache | One year | Right maxillary sinus | NA | Sinusitis | Caldwell-Luc procedure | Free of symptoms |
2 | Basturk FB et al [] (2019)16 | 40 | Gates-Glidden drill | During endodontic treatment | Perforating the root | Asymptomatic | Immediately | Left maxillary sinus | NA | None | Caldwell-Luc procedure | Free of symptoms |
3 | Marques FCC et al [] (2017)30 | 52 | Dental tissue | Displacement during dental implant | Floor of maxillary sinus | Asymptomatic | Immediately | Left maxillary sinus, near the distal root of first molar | 3×8 mm | None | Caldwell-Luc procedure | No complaints or any episodes of inflammation. Normal maxillary sinus |
4 | Tanasiewicz M et al [] (2017)19 | 45 | Root canal filling with extrusion of endodontic obturation material | During endodontic treatment | NA | Orbital and buccal pain on the right side of face and headaches | 6 months | Right maxillary sinus | NA | NA | open surgical approach? | No clinical symptoms, orbital pain and headaches were eliminated after 6 weeks |
5 | J. Hajiioannou et al [] (2016)21 | 28 | Dental synthetic material | During denervation procedure to the ipsilateral second premolar | Unknown | Left sided sinusitis, not respond to medications | One year | Left maxillary sinus | 3 cm | Sinusitis | Caldwell-Luc procedure | Free of symptoms after 6 months of removal |
6 | Saruhan N et al [] (2016)14 | 26 | Tooth root | Tooth extraction | NA | Pain on the right side of the face | NA | Right maxillary sinus | NA | Sinusitis | MMA | Free of symptoms |
7 | Deniz Y et al [] (2016)15 | 63 | Dental silicone impression material | NA | Oroantral fistula | Pain during palpation on left maxillary sinus, chronic headaches, | 4 years | Left maxillary sinus | NA | Chronic sinusitis | Transnasal endoscopy | NA |
8 | Sireci et al [] (2015)20 | 77 | Dental implant | During dental extraction and implantation | Floor of the left maxillary sinus | Left purulent rhinorrhea and parasthenia in the left maxillary region | 3 months | Left maxillary sinus | NA | Left oroantral fistula | Middle meatal antrostomy (MMA) | Free of symptoms |
9 | Al Nashawany et al [] (2014)12 | 50 | Tooth root | Displa-cement during tooth extraction | Left maxillary antrum | Nasal regurgitation of fluids and food. Recurrent maxillary sinusitis | Two years | Left maxillary sinusitis | NA | Sinusitis and oroantral fistula | Endonasal endoscopic sinus surgery | NA |
10 | Sohn et al [] (2011)13 | 27 | Tooth root | Tooth extraction | NA | Asymptomatic. | Immediately | Right maxillary sinus | NA | None | Lateral window approach | NA |
11 | Sohn et al [] (2011)13 | 42 | Dental implant | During dental implantation | NA | Asymptomatic. | Immediately | Right maxillary sinus | NA | None | Lateral window approach | NA |
12 | Sohn et al [] (2011)13 | 27 | Tooth root | During tooth extraction | NA | Asymptomatic | Immediately | Right maxillary sinus | NA | None | Lateral window approach | NA |
13 | Sohn et al [] (2011)13 | 42 | Dental implant | During dental implantation | NA | Asymptomatic | Immediately | Maxillary sinus | NA | NA | Lateral window approach | NA |
14 | Smith et al [] (2007)34 | 28 | Surgical bur | During tooth extraction | Oroantral fistula | NA | NA | Maxillary sinus | NA | NA | Modified Caldwell-Luc procedure; lat antral wall opened | NA |
15 | Liston et al [] (2002)33 | 45 | Six gutta percha | During endodontic treatment | Alveolar process of maxillary bone | Asymptomatic | Immediately | Right maxillary sinus | None | Caldwell-Luc procedure | Free of symptoms | |
16 | Friedlich et al [] (2005)31 | 54 | Surgical bur | During teeth removal | NA | Bleeding from a patent oroantral fistula | Immediately | Sphenoid recess of the left maxillary antrum | 2 cm | Oroantral fistula | FESS | Free of symptoms |
NA – not available; FESS – functional endoscopic sinus surgery; MMA – middle meatal antrostomy. |