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Clinical Problem Solving: Radiology
Aug 2011

Radiology Quiz Case 1: Diagnosis

Author Affiliations
 

SECTION EDITOR: C. DOUGLAS PHILLIPS, MD

Arch Otolaryngol Head Neck Surg. 2011;137(8):826. doi:10.1001/archoto.2011.123-b

Diagnosis: Acute maxillary sinusitis secondary to a migrated dental implant obstructing the ostiomeatal complex

The computed tomographic scout image showed a metallic foreign body at the expected location of the infundibulum (Figure 1). Two similar foreign bodies were seen overlying the hard palate. The coronal reformatted image more precisely defined the location of the foreign body within the infundibulum and showed the severe mucosal thickening that resulted from the obstruction (Figure 2). The radiograph showed 2 dental implants in the appropriate location in the floor of the maxillary sinus and a third dental implant that had migrated into the maxillary sinus infundibulum. Endoscopic sinus surgery (ESS) with concurrent septoplasty was performed to remove the ectopic dental implant.

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