Abstract
We report a case of a foreign body in the right maxillary sinus in combination with a fungal infection.
The patient was a 35 year-old woman with nasal discharge and post nasal drips on the right side, in addition to right cheek pain and headache. She consulted a dentist, following the appearance of these symptoms, and headache. X-ray examination revealed a shadow in the right maxillary sinus, and the patient was admitted to our hospital, for further examination.
Past history included treatment of decay in the 4th and 5th upper right teeth.
She admitted to slight tenderness of the right cheek upon admission to hospital. The head Xray revealed a shadow on the side of right maxillary sinus and the material appeared to be a coilshaped foreign body which was not penetrated by the X-rays at the center of the right maxillary sinus. An examination of topography indicated similar changes, and also the root canal filling material was admitted. CT scan of the sinus showed soft tissue density in the right maxillary sinus and the presence of a high density region suggested the presence of metal at the center, surrounded by a ring of high density area.
Caldwell-Luc surgery was performed under general anesthesia. The maxillary sinus was filled with edematous mucous membrane and caseous material. A coiled string of hard material, approximately 1.5 mm in diameter, was extracted from inside the maxillary sinus. Pathological study revealed the material to be aspergillosis.
After surgery the patient's symptoms, including nasal discharge, post nasal drips and headache, disappeared.
Electron microscopic examination of the exposed sample, suggested it was composed of inorganic matter such as calcium and a chemical analysis indicated that calcium oxalate, and a sulfuric acid of barium were the main ingredients. Root canal filling material was thought to have left the root of the tooth clearing dental treatment, leading to subsequent inflammation in the maxillary sinus, and later to aspergillosis infection.
