Contribution of endoscopy in high sinus inclusions, a case report

Abstract

Introduction: This paper will discuss the management of iatrogenic displacement of the third molar (3M) into the maxillary sinus through a specific case that we have encountered. Observation: This case reports the atypical clinical history of an ectopic intra sinusal 3M of iatrogenic origin, associated with an inflammatory cyst. A 52-year-old man presented with chronic sinusitis and an oral-sinus communication 30 yr after the displacement of his 3M into the maxillary sinus. A minimally invasive multidisciplinary management using endoscopy was proposed to the patient as well as an 18-month follow-up reporting a normalization of his initial sinus symptoms. Discussion: An analysis of the literature concerning intra sinusal teeth was carried out, whatever their etiology, in order to situate our case and to be able to propose the least invasive procedure for these patients. The different surgical approaches are analyzed as well as the effectiveness of a multidisciplinary management. Conclusion: In this case, the simultaneous oral and nasal approach enabled a minimally invasive procedure. The endoscope is now part of the surgeon's therapeutic arsenal, and the training of practitioners in its use could greatly facilitate procedures.