Case of man having tooth in nose reported in NEJM
Dr Sagar Khanna, and Dr Michael Turner at Mount Sinai Health System, New York have reported a rare case of ectopic tooth in nose and the same has been published in the New England journal of Medicine.
The intranasal tooth is an uncommon encounter in clinical practice. Teeth in non-dentate areas including the intra-sinus and intranasal teeth are rarely encountered in clinical practice.
Ectopic or supernumerary teeth can occur in 0.1%-1% of the population , but the incidence of ectopic teeth in the nasal cavity is especially rare.
Although the majority of patients remain asymptomatic, the usual presenting complaints are nasal obstruction, epistaxis, hyposmia and headache. The intranasal ectopic tooth is somehow rare but is potentially harmful when left untreated; thus, surgically removing the intranasal ectopic tooth is important to improve patient's quality of life. Furthermore, the diagnosis is simple, fast, and cheap.
According to the history, a 38-year-old man presented to the otolaryngology clinic with difficulty in breathing through his right nostril, which he said had been ongoing for several years. He reported no history of facial trauma or craniofacial abnormalities. Physical examination of the nose showed a septal deviation, calcified septal spurs, and a 2-cm perforation in the posterior septum. On rhinoscopy, a hard, nontender, white mass was observed in the floor of the right nostril (Panel A). Computed tomography of the paranasal sinuses showed a well-defined, radiodense mass consistent with an inverted ectopic tooth in the nasal cavity (Panel B, arrow), which was thought to explain the obstructive symptoms and septal perforation. The tooth was removed during oral and otolaryngologic surgery by means of an intranasal approach and measured 14 mm in length. There were no postoperative complications. At follow-up 3 months after surgery, the patient's symptoms of nasal obstruction had resolved.
Carry home message is that combined clinical and radiological approach helps to accurately diagnose the condition and plan the appropriate management.
For further reference log on to:DOI: 10.1056/NEJMicm2112363
