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83rd Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

16.05. - 20.05.2012, Mainz

Unilateral sinusitis as a case of occult maxillary ameloblastoma

Meeting Abstract

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  • corresponding author presenting/speaker Sarah Runge - St. Vincentius-Kliniken Karlsruhe, Klinik für HNO-Heilkunde, Karlsruhe, Germany
  • Peter Joram - St. Vincentius-Kliniken Karlsruhe, Klinik für HNO-Heilkunde, Karlsruhe, Germany
  • Helene Geddert - St. Vincentius-Kliniken Karlsruhe, Institut für Pathologie, Karlsruhe, Germany
  • Jürgen Mertens - St. Vincentius-Kliniken Karlsruhe, Klinik für HNO-Heilkunde, Karlsruhe, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 83rd Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Mainz, 16.-20.05.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12hno54

DOI: 10.3205/12hno54, URN: urn:nbn:de:0183-12hno549

Published: July 23, 2012

© 2012 Runge et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Introduction: There are situations in which common diagnostics of jaw and sinus, such as methods of physical examination and imaging, do not initiate conspicuousness. We report on such a case, a maxillary ameloblastoma. Ameloblastoma is a benign, locally invasive growing tumor of the jaw. Maxillary ameloblastomas are rare. Clinically, it attracts attention mostly by a painless swelling of the jaw. As further symptoms occur often only with delay, the tumor may reach an enormous size and ameloblastomas may have already infiltrated adjacent tissue and destroyed middle face structures, before they are diagnosed.

Methods and Results: In our case a 43-year-old patient showed recurrent symptoms of acute sinusitis. He denied dental complaints. Nasal endoscopy revealed a swelling of the medial maxillary sinus wall with narrowing the nasal cavity. A CT-scan presented a unilateral opacification of the left maxillary, ethmoid and frontal sinuses. Also a dental examination did not provide any clue. A deep periodontal defect was present in tooth 28, but no causal pathological findings were collected. The Orthopantomogram (OPG) showed no abnormalities. Sinus surgery was performed, where we could identify an infiltrative process in the area of the left maxillary sinus floor and the lateral maxillary sinus wall. Finally, the histological examination could reveal a conventional ameloblastoma.

Conclusion: Ameloblastomas usually attract attention by a painless swelling of the jaw and the radiographic imaging showing a unilocular radiolucency. In our case, there was no evidence for a dental genesis of the sinusitis complaints and only the histologic result could reveal the cause. This emphasizes the importance of a biopsy for diagnosis. Hence, Ameloblastomas can be regarded as a rare cause of unilateral sinusitis, but should be taken into account when considering differential diagnosis.


References

1.
Schwenzer N, Ehrenfeld M, eds. Zahn-Mund-Kiefer-Heilkunde Bd 2: Spezielle Chirurgie. Stuttgart, New York: Thieme. p.148-149.
2.
Koscielny S, Stebel S. The ameloblastoma as differential diagnosis of tumors of the paranasal sinuses. Laryngorhinootologie. 2010 Jun;89(6):367-8.
3.
Braun T, Ihrler S, Kisser U, Leunig A. Cystic lesion with a displaced tooth in the maxillary sinus. HNO. 2011 Jul;59(7):700-4.
4.
Zwahlen RA, Grätz KW. Maxillary ameloblastomas: a review of the literature and of a 15-year database. J Craniomaxillofac Surg. 2002 Oct;30(5):273-9.
5.
Eckardt AM, Kokemüller H, Flemming P, Schultze A. Recurrent ameloblastoma following osseous reconstruction – A review of twenty years. Journal of Cranio-Maxillofacial Surgery. 2009;37:36-41.