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Case 97


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A 48-year-old female patient presented to the ENT outpatient department of Hospital das Clínicas, in Belo Horizonte, Brazil, with headache, nasal obstruction, non-purulent nasal discharge and right-sided facial pain. She had been previously treated with antibiotics without significant clinical improvement. She denied fever. She also reported having undergone a surgical removal of an odontogenic cyst ten years before, which was complicated by a right-sided oroantral fistula. Normal-sized nasal turbinates were observed on examination. A computed tomography of the paranasal sinuses was requested.

Based on the clinical scenario and image presented, the most likely diagnosis is:

a) Fungal sinusitis


b) Tumor of the maxillary sinus


c) Odontogenic sinusitis


d) Nasosinusal polyposis



  • - Sinusitis of odontogenic origin should be suspected in patients with unilateral chronic maxillary sinusitis and prior history of dental procedures.
    - The computed tomography is useful for establishing the diagnosis, assessing the disease extension and planning the surgical approach.
    - Treatment of the underlying dental condition is of utmost importance.
    - Surgery (Caldwell-Luc procedure) might be indicated in order to retrieve dislodged root and/or tooth fragments.


  • - Costa SS, Cruz OLM, Oliveira JAA et al. Otorrinolaringologia: Princípios e Práticas. 2ª edição. Porto Alegre: Artmed, 2006. 
    - Escoda C, Aytés L. Sinusitis odontogénica. In: Escoda C, Aytés L. Tratado de Cirurgía Bucal. 1th ed. Espanha: Ediciones Ergon, 2004: 687-708. 
    - Lee KC, Lee SJ. Clinical Features and Treatments of Odontogenic Sinusitis. Yonsei Med J. 2010 November 1; 51(6): 932–937.


Lucas Fonseca Rodrigues, 3rd year medical student of UFMG School of Medicine. E-mail: lucasbhfonseca[at]


Dr. Roberto Eustáquio Guimarães, member of the Department of Otorhinolaryngology and Ophthalmology (UFMG School of Medicine). E-mail: resguimaraes[at]


Raphael Penholati, Renato Campanati and Professor Viviane Parisotto

Translated by

Lucas Resende Lucinda, 6th year medical student of UFMG School of Medicine. E-mail: lucasresendebh[at]


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