The First Case of Endoscopic Transnasal Removal of an Ectopic Molar Tooth from the Pterygomaxillary Fossa: A Low Morbidity Approach

Abstract

 Ectopic teeth erupted in the maxillary sinus (MS) or Pterygomaxillary Fossa (PF) are rarely 
reported. Though often asymptomatic, patients with ectopic teeth in the MS or PF may suffer 
from facial pain/numbness, purulent nasal discharge, facial edema, epiphora, and haemoptysis. 
Caldwell-Luc procedure is traditionally performed to remove ectopic teeth from the sinus, 
though several side effects and complications have been reported. The maxillary facial pain and 
numbness following such procedure can be extremely bothersome. This paper reports the case 
of a young woman suffering from maxillary facial pain and swelling due to an ectopic molar 
tooth in the PF and related maxillary sinusitis. Tooth removal and MS cleaning were carried 
out through a transnasal endoscopic approach. The postoperative course was uneventful. The 
patient did not complain any facial pain or numbness. We conclude that transnasal endoscopy 
is a painless and easy approach for the removal of ectopic teeth from the PF thanks to the low 
morbidity of intranasal antrotomy and advantages of endoscopic vision.