Ectopic Tooth in the Nasal Cavity Following Maxillary Ameloblastoma Resection
By Wanhong LiangAffiliations
doi: 10.29271/jcpsp.2025.12.1639Sir,
Intranasal ectopic teeth (IET) are exceptionally rare, with an estimated prevalence of 0.1%-1% in the general population and a noted male predilection (60–70% of cases).1-5 The exact aetiology remains unclear; however, trauma, infection, and developmental disorders have been hypothesised as possible reasons. Notably, most cases lack identifiable causes.
A 25-year man presented with persistent right-sided nasal discharge and pain. He had previously undergone surgical excision of a right maxillary sinus cyst in 2012 for similar symptoms. In 2013, due to suspected recurrence of the cyst, he underwent a second maxillary sinus cyst excision. Pathological examination again confirmed a benign lesion. Persistent symptoms prompted him to seek surgical intervention again in 2014, when a pathological examination confirmed the diagnosis of ameloblastoma. His postoperative recovery was uneventful, and his symptoms resolved completely.
Figure 1: CT images of the ectopic tooth. (A) Axial: CT scan shows the ectopic tooth (arrow). (B) Coronal: The ectopic tooth was located at the inferior margin of the maxillary sinus.
Figure 2: (A) Endoscopic image of the ectopic tooth. (B) Specimen of the ectopic tooth.
In 2023, the patient returned with recurrent right-sided nasal discharge accompanied by epistaxis. Nasal cavity examination revealed a white mass. Computed tomography (CT) scan confirmed the presence of an ectopic tooth within the right nasal cavity (Figure 1A and B). Nasal endoscopy revealed a pearly white mass extending from the nasal floor (Figure 2A). The patient subsequently underwent endoscopic removal of the ectopic tooth under general anaesthesia (Figure 2B). Intraoperative findings revealed the absence of the right inferior turbinate and a patent right maxillary sinus ostium. Within the sinus, cystic tissue was found encapsulating the tooth. The nasopharynx appeared grossly normal. The surgeon performed radiofrequency ablation of the cystic tissue using a plasma knife probe, extracted the tooth, and obtained biopsy samples of the cystic tissue for pathological analysis. Pathological examination showed no evidence of tumour recurrence. The ectopic tooth was likely a result of the patient's prior maxillary pathology. Postoperatively, the patient experienced favourable mucosal healing without crusting. His symptoms resolved completely, and he reported no dysaesthesia.
This case is the first reported instance of the ectopic tooth following surgical resection of maxillary sinus ameloblastoma, diverging from the previous literature, which primarily attri-buted nasal ectopia to congenital factors. Endoscopic removal, as the preferred treatment, effectively mitigates complications from nasal foreign bodies, aligning with the established surgical protocols. This rare case highlights long-term surgical risks and supports endoscopic management.
COMPETING INTEREST:
The author declared no conflict of interest.
AUTHOR’S CONTRIBUTION:
WL: Drafting, revision, editing, analysis, interpretation, and the final approval of the manuscript to be published.
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