Iatrogenic foreign bodies in the maxillary synus: between malpraxis and medico-legal consequences
نویسندگان
چکیده
Objectives: Due to the continuous development of invasive dental procedures, presently we encounter a permanent growing of medical complications, like protrusion of foreign bodies into the maxillary sinus during therapeutic maneuvers on the superior dental arch. Plus that we can find neglected foreign bodies in the maxillary sinuses after ENT surgical procedures. With this clinical study we evaluated the most frequent etiology of the iatrogenic foreign bodies of the maxillary sinus, the improper surgical maneuvers that can lead to protrusion of foreign bodies, and the complications produced by these. Material and methods: We performed a prospective clinical study on 49 consecutive patients with various types of foreign bodies of the maxillary sinus admitted in our Department between January 2010 January 2013. In all cases we performed craniofacial CT scans and dental panoramic radiography. The removal of the foreign bodies was performed surgically. Results: Most common foreign bodies encountered were dental implants (19 patients, representing 38.77%), followed by amalgam fragments (14 patients, 28.57%), Guttapercha points (5 patients, 10.20%), pieces of gauze used for nasal or sinusal packing (4 patients, 8.16%), tooth fragments (3 patients, 6.12%), dental burr (2 patients, 4.08%), Kerr needles (2 patients, 4.08%). The complications encountered were: acute or chronic rhinosinusitis (37 patients 75.51%), with 11 cases of fungal colonization proved at histopathological exam, and the rest of 26 rhinosinusitis patients with bacterial infection, 12 cases of oro-antral fistula (24.29%), 1 case of orbital abscess, 1 case of malar abscess. Conclusion: Most of the cases of iatrogenic foreign bodies in the maxillary sinus are due to inadequate dental treatments. Dental implants and root canal fillings materials are the most frequent iatrogenic FB inserted into the maxillary sinus. Untreated, they can produce inflammatory – infective sinus pathology, like bacterial or fungal sinusitis, or even abscesses of the surrounding
منابع مشابه
Extracorporeal Foley catheter spring device mimicking an intervertebral foreign body in transforaminal lumbar interbody fusion surgery.
The complications caused by iatrogenic foreign bodies are well known, but cases are rarely published because of the medico-legal implications.1 Early identification of a foreign body can prevent hazardous and detrimental complications. Medical practitioners may occasionally be misled by overlapping images of radio-opaque objects on X-rays and misinterpret these as foreign bodies. We present a c...
متن کاملPostoperative Adhesive Intestinal Obstruction from Gossypiboma
Retained foreign bodies after surgery is a rare condition which can have medico-legal consequences. Foreign bodies forgotten in the abdomen include towels, artery forceps, pieces of broken instruments or irrigation sets, and rubber tubes. The most common surgically retained foreign body is the laparotomy sponge. Such materials cause foreign body reaction in the surrounding tissue. The complicat...
متن کاملAn unusual case of maxillary sinus trauma
Maxillary sinus foreign bodies are commonly due to penetrating trauma and iatrogenic events. A foreign body is usually identified during initial assessment and subsequently removed. We present a rare method of maxillary sinus trauma with retained and subsequent discharged foreign body twelve years following the initial injury.
متن کاملRetained sponge after abdominal surgery: experience from a third world country
BACKGROUND Retained abdominal sponge after surgery is a quite rare condition which can have heavy medico-legal consequences; its frequency is generally underestimated. Few reports of these conditions are available in African environment with specific technical and medico-legal background. We present our local experience of retained sponges after abdominal surgery and review current literature. ...
متن کاملChronic Maxillary Sinusitis Associated with an Unusual Foreign Body: A Case Report
Foreign bodies in maxillary sinuses are unusual clinical conditions, and they can cause chronic sinusitis by mucosal irritation. Most cases of foreign bodies in maxillary sinus are related to iatrogenic dental manipulation and only a few cases with non-dental origin are reported. Oroantral fistulas secondary to dental procedures are the most common way of insertion. Treatment is surgical remova...
متن کامل