Article
Impairment of Masticatory Function as the first Symptom of an Esthesioneuroblastoma of the Right Maxillary Sinus
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Published: | July 22, 2009 |
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Introduction: A progressive disturbance of masticatory function is a common symptom in the otorhinolaryngological field. The causes for this vary and reach from inflammations of the oral cavity to lesions of the upper gastrointestinal tract up to neurological and psychiatric illnesses. Although the sinuses are not directly involved in the ingestion of nutrients, tumors of this region are able to cause the discomfort mentioned above.
Case report: A 69-year-old patient presented with an insufficient hold of the upper jaw prosthesis existing for approx. 3 weeks and thus resulting in chewing difficulties. Besides, she noticed increased rhinorrhea of the right nasal cavity. She complained also about a swelling of the right facial half, loss of weight and night sweat.
The endonasal inspection showed a grayish-crumbly disintegrating tumor. At enoral investigation of the hard palate we saw a solid mass on the right side.
The CT scan of the paranasal sinuses demonstrated a 4.5 to 7cm space occupying lesion in the right maxillary sinus with destruction of the sinus walls and infiltration to the neighborhood. The histology established the diagnosis of an esthesioneuroblastoma.
The tumor was treated by a resection of the right maxilla and orbital floor. Its reconstruction was accomplished with a titan mesh according to the orbital floor and a musculocutaneous flap from the right m. latissimus dorsi.
Conclusion: Even a chewing disturbance, caused by an insufficient hold of a prosthesis, can show as a first symptom of tumors inside the nasal sinuses and should be thoroughly evaluated.
References
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