Idiopathic bilateral antral exostoses: A rare case in maxillary sinus

Abstract

INTRODUCTIONExostoses in paranasal sinuses have been reported in the otolaryngology literature, but they have not been described in the dental literature to our knowledge. The aim of this article is to describe an idiopathic and rare case of bilateral exostosis obtained by cone-beam computed tomography.PRESENTATION OF CASEThe case shows a healthy and asymptomatic patient with a different size and form of exostoses in both maxillary sinuses.DISCUSSIONIt is difficult to clinically diagnose the antral exostosis due the asymptomatic nature of this condition, unless the approach would be through endoscope. Sometimes this condition is related with nasal irrigants, however in this case the patient asserted not having used nasal irrigation ever; thus, it is impossible to relate this kind of treatment as a principal cause.CONCLUSIONThe published data of exostoses in maxillary sinus seem to be limited in the dental literature, and this condition is important to consider in an implant treatment planning. Also, it is important to perform a follow-up of the cases in trying to find the possible causes of exostosis.

The prevalence of antral exostoses in the maxillary sinuses, evaluated by cone-beam computed tomography

“…The number of individuals with antral exostoses had a female predilection in published case reports (Table 4). Antral exostoses have been reported in individuals 22–66 years old 2, 20, 21, 22, 23, 24, 25. In our study, this ratio was 1.4:1 with a female predominance, but no statistically significant difference existed between the sexes.…”

“…Ohba et al 3 found that the average size of these lesions was 4.7 mm × 7.4 mm. Borie et al 25 in their case report defined the size of these lesions as 6.3 mm × 9.8 mm in the right sinus and 15.4 mm × 9.4 mm in the left sinus 25 . The relatively low average dimensions of the lesions in our study can be explained by the difference between the radiographic techniques used.…”

“…Case reports by Ramakrishnan et al 2 and Schwartz et al 24 described bilateral exostoses, although the case report by Borie et al 25 described unilateral lesions. There were no bilateral exostoses in the research by Ohba et al 3 .…”

“…The symmetry (i.e., unilateral or bilateral) of antral exostoses between contralateral sides in the same patient, and the side (i.e., right or left) were also recorded. The sizes in the mesiodistal, inferosuperior, and anteroposterior directions of the antral exostoses were measured in millimeters 3, 25…”

“…Several reports exist in dentistry and otolaryngology literature regarding this entity 2, 3, 22, 23, 24, 25. However, published articles on antral exostoses are mostly case reports or studies investigating incidental findings and/or pathologies in the maxillary sinuses 2, 20, 21, 22, 23, 24, 25, 26. To our knowledge, only two studies have analyzed the prevalence of antral exostoses 3, 26.…”