Japanese dentists have described a case of a tooth forming in a child's nasal cavity. The tooth was found during a routine examination and did not cause any discomfort, but to avoid future inflammation, surgeons removed it through the nose under general anesthesia. The case, which is described in BMJ Case Reports, is rare not only because the tooth was located in the nose, but also because it was not connected to the upper jaw in any way, but was attached to the nasal septum as a polyp.
Polyodontia is a condition in which a person develops teeth in addition to the standard set. It occurs in 0.1-1 percent of people and occurs due to a violation of the formation of tooth rudiments. Additional teeth are most often isolated and are usually located next to the main set of teeth. Rarely, teeth are found in the nasal cavity: a total of 80 such cases have been described in English-language literature, with only 14 such teeth not having contact with the bone. Such teeth may often not be accompanied by obvious symptoms and are detected only by radiography. Over time, they can become inflamed or interfere with nasal breathing, so such teeth are usually removed.
Himiko Umezawa from Saisekai Yokohamashi Nanbu Hospital and colleagues described a case of intranasal tooth in a child. A primary school-aged boy was brought to the dental department for malocclusion, and when he underwent routine orthopantomography, a tooth-like formation was found in the right nasal cavity. The boy did not complain and breathed freely through his nose. A visual examination by an otolaryngologist revealed no pathologies, and a dentist confirmed malocclusion, but all other molars were in place.
The CT scan showed a tooth with its crown turned toward the pharyngeal side of the base of the nasal cavity. At the same time, the tooth was in the nose without contact with the maxillary bone. Based on the CT scan, the boy was diagnosed with an additional intranasal tooth and surgery was planned.
Surgeons removed the tooth endoscopically through the nasal cavity under general anesthesia. It turned out that it was attached to the nasal septum in the form of a polyp. The tooth was fully formed and reached 15 millimeters in length. The patient was monitored for a month after the operation - the boy did not have any complications.
The exact cause of ectopic teeth is unknown. The authors of the work believe that this occurs due to excessive activation of the dental plate, with the tooth rudiment separating from the main part of the plate and migrating into the nasal cavity. In this clinical case, it is also interesting that the tooth was not connected to the bone in any way, but was located in the form of a polyp in the nasal cavity.
With the help of X-ray diagnostics, doctors find not only additional teeth. Sometimes the findings are even more unusual: for example, dental implants in the maxillary sinus or a nail in the brain. Read about these and other strange findings on CT in our article “Surprises in a Cut”.
