2019 Volume 18 Issue 2 Pages 61-67
The purpose of this article is to report an extremely rare case of Aspergillosis of the maxillary sinus involved with implant treatment.
A 67-year-old woman visited our hospital with a chief complaint of rhinorrhea, nasal obstruction and discomfort in her buccal area. On oral examination, 2 implants in the maxillary molar had neither percussion pain nor mobility, showing antraoral communication through periodontal pocket. CT revealed that the sinus was occupied by heterogeneous soft tissue density area including a few calcification area called fungus ball, foamy low density area in the right maxillary and ethmoid sinus without bone destruction, and thicken bone of antral wall, soft tissue density bulged out toward the nasal cavity. We made clinically diagnosed as fungal maxillary sinusitis, and performed removal of implants and curettage of the maxillary sinus with the surgical drainage duct. The histopathological diagnosis showed aspergillosis of the maxillary sinus. Therefore we made final diagnosis as non-invasive type, aspergillosis of the maxillary sinus. Since then the postoperative course has been uneventful. Her symptoms have been completely improved. The 8 months postoperative CT revealed normal thin mucosa in the maxillary and ethmoid sinus.
The findings of CT were useful and effective for diagnosis in this case. To our knowledge, they have been ever documented in only 2 English reports regarding to aspergillosis of the maxillary sinus involved with implant treatment, and no report in Japan. This article is the first report in Japanese one.