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An asymptomatic foreign body in a maxillary sinus ostium.


A 68-year-old woman was referred to us with recurring right sinusitis and right facial discomfort that had responded poorly to long-term medical treatment. Computed tomography (CT) of the sinuses detected chronic tight maxillary max·il·lar·y (mks-lr and ethmoid
1. sievelike; cribriform.
2. the ethmoid bone; see Table of Bones. .ethmoi´dal


eth·moid (thmoid
 sinusitis in addition to a metallic foreign body for·eign body (fôrn)
n.
An object or entity in the body that has been introduced from outside.
 in the left maxillary sinus. The foreign body appeared to be in the area of the natural ostium
ostium abdomina´le tu´bae uteri´nae  the funnel-shaped opening where the uterine tube meets the abdominal cavity.
coronary ostium  either of the two openings in the aortic sinus that mark the origin of the (left and right) coronary arteries.
ostium inter´num u´teri  o. uterinum tubae uterinae.
 of the left maxillary sinus (figure, A). The patient had no history of left facial discomfort or left sinus symptoms. Of note was the history of the patient's extensive dental work, which included the placement of dental implants 12 years earlier.

The patient underwent right functional endoscopic sinus surgery for drainage purposes. At the same time, endoscopic exploration of the left maxillary sinus was carried out by first identifying the left uncinate process (figure, B) and then by removing the left uncinate process via a retrograde
1. Moving or tending backward.
2. Opposite to the usual order; inverted or reversed.
3. Reverting to an earlier or inferior condition.
v.
1. To move or seem to move backward; recede.
2. To decline to an inferior state; degenerate.
 approach (1) with a microdebrider (figure, C). The foreign body was found to be embedded in the natural ostium of the left maxillary sinus. The natural ostium was enlarged posteriorly and inferiorly, which allowed us to remove the foreign body. It appeared to be a post used for dental reconstruction (figure, D). The patient had an uneventful postoperative course.

In the maxillary sinus, mucociliary mucociliary /mu·co·cil·i·ary/ (mu?ko-sil´e-ar-e) pertaining to mucus and to the cilia of the epithelial cells in the airways. clearance is always directed toward the natural ostium. (2) It is interesting to note that the foreign body in this patient had traveled and lodged in the natural ostium. Its presence was asymptomatic a·symp·to·mat·ic (smp-t-m, however, because it did not completely obstruct the natural ostium. Maxillary sinus infections have frequently been described as being caused by dental problems. (3) Some of these problems occur when a foreign body of dental origin causes an obstruction of the natural ostium of the maxillary sinus.

The finding of an asymptomatic metallic dental foreign body embedded in a maxillary sinus for many years is not a common occurrence.

[FIGURE OMITTED]

References

(1.) Christmas DA, Yanagisawa E, Joe JK Transnasal endoscopic identification of the natural ostium of the maxillary sinus: A retrograde approach. Ear Nose Throat J 1998:77:454-5.

(2.) Hilding AC. Experimental sinus surgery: Effects of operation windows on normal sinuses. Ann Otol Rhinol Laryngol 1941; 50:379-392.

(3.) Lin PT, Bukachevsky R, Blake M. Management of odontogenic
1. forming teeth.
2. arising in tissues that give origin to the teeth.


o·don·to·gen·ic (-dn
 sinusitis with persistent oro-antral fistula Ear Nose Throat J 1991:70:488-90.

From the Department of Otolaryngology
oto·laryn·golo·gist n.
, University of South Florida College of Medicine. Tampa, and Halifax Medical Center, Daytona Beach, Fla. (Dr. Christmas and Dr. Mirante); and the Section of Otolaryngology, Hospital of St. Raphael, New Haven, Conn., the Section of Otolaryngology. Yale University School of Medicine, New Haven, and the Southern New England Ear, Nose, and Throat and Facial Plastic Surgery Group, New Haven (Dr. Yanagisawa).
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juniebug77i
sally (Member): foreign body left in my sinus 12/17/2007 9:26 PM
after having four implants placed, two of them failed and pulled.one was placed in different place. <br> dentist used faulty plastic temporaries to work as a temp prothesis for three implants until they heal.<br>the temps were constructed in one piece, and i only had one tooth on my upper with attachments to the three healing implants.<br>they must have broken at least 25 times.!!!!<br>to make a long story short...... AFTER AN IMPARTIAL DENTIST TOOK A PANAREX AND DISCOVERED WHITE OBJECT.<br>$10,000 later with sinus surgery to remove what is 99%, a plastic temp that migrated through a hole he left in my gum after removal of implant. HE IS TELLING ME HE HAD NOTHING TO DO WITH IT, 5/8" LONG X 1/4 WIDE. HE WILL NOT HELP WITH ANY MEDICAL BILLS. WHAT SHOULD I DO? BUT WHAT IS MY RECOURSE? HE TURNED OUT TO HAVE MISREPRESENTED THE ENTIRE TREATMENT PLAN.<br>PLEASE ADVISE. THANK YOU

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Article Details
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Title Annotation:Rhinoscopic Clinic
Author:Yanagisawa, Eiji
Publication:Ear, Nose and Throat Journal
Geographic Code:1USA
Date:Dec 1, 2003
Words:452
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