Supernumerary Tooth: Endoscopic Removal for a Rare Cause of Recurrent Epistaxis
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CLINICAL REPORT
Supernumerary Tooth: Endoscopic Removal for a Rare Cause of Recurrent Epistaxis Madhu Priya1 • Sofia Doomra1 • Sumeet Angral1 • Manu Malhotra1,2 • Abhishek Bhardwaj1 • Saurabh Varshney1 • Areej Moideen1 • Manish Kumar Gupta3
Received: 10 September 2020 / Accepted: 12 October 2020 Ó Association of Otolaryngologists of India 2020
Abstract The presence of ectopic (supernumerary) teeth is common odontogenic problem in clinical practice. Its presence in dentate region is common but rare in the non dentate areas such as nose and maxillary sinus. The intranasal teeth generally remain asymptomatic but can get misdiagnosed for foreign body, or may present as complications like headache, epistaxis, nasal obstruction, rhinolith formation, oroantral fistula and sinusitis. Here, we discuss a case of intranasal tooth as a rare cause of profuse and recurrent epistaxis. The clinical, radiological findings
and surgical treatment via endoscopic approach of this rare entity has been discussed. This interesting case report highlights the need to look beyond nose as cause for epistaxis. Endoscopic removal for this entity can be a preferred option to help minimize complications. Keywords Epistaxis Supernumerary tooth Intranasal tooth Endoscopic removal
Introduction & Manu Malhotra [email protected] Madhu Priya [email protected] Sofia Doomra [email protected] Sumeet Angral [email protected] Abhishek Bhardwaj [email protected] Saurabh Varshney [email protected] Areej Moideen [email protected] Manish Kumar Gupta [email protected] 1
Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttrakhand, India
2
Department of ENT, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
3
Department of Paediatric Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
Epistaxis—Greek word for nosebleed that means ‘‘leaking on, drop by drop’’—is a problem that has been a part of the human experience from ancient times [1]. Approximately 60% population will suffer from epistaxis at least once in their lifetime [2]. Local causes of epistaxis within the nose include anatomical anomalies (septum deviation with septal spur), nasal injury (foreign body, fractures), rhinitis, medications (nasal sprays-decongestants and sprays), chemical irritants (cocaine abuse, ammonia), intranasal tumors-benign (e.g. inverted papilloma, angiofibroma) and malignant [3]. Systemic causes may include hepatic disease (hepatic and cirrhosis failure), cardiovascular diseases (e.g. atherosclerosis and systemic arterial hypertension), hematologic diseases (von Willebrand disease, hemophilia etc.), endocrine causes (pheochromocytoma, puberty) and systemic medication (NSAIDs, anticoagulants) [3]. Epistaxis could rarely be caused by unerupted incisor tooth in the nasal cavity. Tooth eruption begins in the intra alveolar bone to finally grow and move to its oral cavity position. During its growth and movement man
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