2024 Volume 63 Issue 1 Pages 112-118
The mechanism underlying development of intranasal inverted teeth is not fully understood. Here, we report a rare case of bilateral intranasal inverted teeth. A 2-year-old girl who had a cough was diagnosed with bilateral intranasal masses at an ENT clinic, as well as suspected inverted teeth in the nasal cavity. Sinus CT showed a tooth-like shadow in the nasal cavity on both sides, accompanied by a translucent image in the center. Considering her young age and the narrowness of the nasal cavity, endoscopic sinus surgery was performed at age 7 years. Bilaterally, the inverted teeth only adhered to the nasal mucosa and were pedunculated, making removal easy. Histopathological examination confirmed the diagnosis of inverted teeth, and the postoperative course was uneventful.
A review of the literature indicates that more than 60% of intranasal inverted teeth are supernumerary teeth with similar features, including age at diagnosis, a higher rate in males, and more inverted teeth on the left. In our case, the inverted tooth on the right side was located lower than that on the left side on CT at the first visit, and was in contact with the nasopalatine duct. However, 2 years and 5 months later, CT showed that the tooth had separated from the maxilla and was present in the nasal cavity. Sagittal evaluation was useful for determining the position and mechanism of the inverted teeth; for example, supernumerary teeth might erupt into the nasal cavity from the interincisal suture or near the nasopalatine duct. With bilateral intranasal inverted teeth, diagnosis may be difficult if the lesion is symmetrical. To prevent complications, such as delayed eruption of permanent teeth and abnormal dentition, it is important to consider inverted teeth as a differential diagnosis in cases with intranasal masses.
