口腔インプラントに起因した歯性上顎洞炎を合併した鼻腔内反性乳頭腫例

概要

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A 67-year-old man presented with left nasal obstruction and mucopurulent discharge. CT showed shadows at his left sinuses, and implant extension into the left maxillary sinus cavity with an osteolytic lesion around that equivalent to the left side maxillary second molar. Our diagnosis in this case was left maxillary sinusitis related to a dental implant, and we performed endoscopic sinus surgery with implant extraction. Postoperatively, a complication involving sinonasal inverted papilloma (IP) was diagnosed with a histopathological examination. Residual lesion or recurrence has not occurred so far and all patient symptoms disappeared during the follow-up period. Dental implants are widely used and their use is increasing rapidly. On the other hand, cases of maxillary sinusitis caused by inadequate dental implant treatment have been reported. IP is one of the most frequent sinonasal benign tumors, and there are various differential diagnoses, including antrochoanal polyp, and odontogenic maxillary sinusitis. We should keep in mind that IP may occur in unilateral nasal polypoid cases, including cases suspected as being odontogenic maxillary sinusitis. Such masked lesions might not be detected if the treatment is performed by an oral surgeon alone; therefore, we think it is important that oral surgeons and otolaryngologists should make the diagnosis and perform the treatment together.