An ectopic tooth – rare cause of nasal breathing obstruction

Intranasal teeth occur with an incidence of 0.1 to 1 % of the population and are commonly found in the palate, maxillary sinus and the floor of the nasal cavity. Etiological causes can be dental trauma, nasal infections, genetic factors and cleft lip in children. Ectopic intranasal teeth are usually asymptomatic and an incidental finding.

A 25 year-old male presented with a history of nasal breathing obstruction for several years. Post nasal drip, facial pain and hyposmia were denied so no preoperative imaging was carried out. Rhinoscopy showed a septal deviation to the right side with a prominent septal crest as well as hypertrophy of the inferior nasal turbinates. Rhinomanometry showed moderate obstruction of nasal breathing on both sides. A septoplasty with bilateral turbinate reduction was recommended. Intraoperatively we removed the deviated bone after we lifted the mucosal lining from the septum. Inside the septal crest an ectopic tooth was found, which caused the septal deformity.

Ectopic intranasal teeth are a rare cause of nasal breathing obstruction. Some of them can already be detected during the clinical examination. Prompt surgical removal is recommended to avoid complications like rhinosinusitis, osteomyelitis, dacrocystitis, septal abscess, fistulas and nasal deformation. If an ectopic tooth is suspected preoperatively a CT-Scan should be performed. Endoscopic removal can be necessary depending on the location of the tooth.

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Artikel online veröffentlicht:
10. Juni 2020