CitationLuca DA, Fabio P, Filippo LR, Marco P. The first case of endoscopic transnasal removal of an ectopic molar tooth from the pterygomaxillary fossa: a low morbidity approach. Case Report ABSTRACTEctopic 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.