Ectopic odontomas are a rare disease process and need to be in the differential of the Otolaryngologist and Radiologist. Previous reports reveal the most common location to be the maxilla. We present a rare case of odontoma involving a turbinate causing nasal obstruction and foul-smelling rhinorrhea. Surgical excision is the treatment of choice with an endoscopic approach, if feasible.
Ectopic odontomas are a rare disease process and need to be in the differential of the Otolaryngologist and Radiologist. Previous reports reveal the most common location to be the maxilla. We present a rare case of odontoma involving a turbinate causing nasal obstruction and foul-smelling rhinorrhea. Surgical excision is the treatment of choice with an endoscopic approach, if feasible.
A 54-year-old female presented with complaints of chronic right-sided nasal obstruction, rhinorrhea and a foul odor emanating from the nostril. The patient was otherwise healthy and reported only seasonal allergies and hypertension in her past medical history. On physical exam, there appeared to be a bony concretion in the floor of the right nasal cavity, impinging against the septal wall. A CT scan of the sinuses was performed and showed an expansile, centrally calcified lesion within the right nasal cavity involving the inferior turbinate and obstructing the inferior meatus (
was no bony destruction; however, there was thinning and possible erosion of the septum. There appeared to be no association to the underlying maxillary alveolar bone. The patient underwent endoscopic removal of the calcified mass and the histopathology contained two fragments of dentin (
Odontomas are the most common odontogenic tumor, containing both epithelial and mesenchymal elements such as enamel, dentin, pulp and cementum [
The radiographic assessment of our patient showed a radiopaque mass involving the right inferior turbinate. There did not appear to be any relationship to the maxillary alveolar tooth bearing bone. The histopathology of our specimen showed fragments of dentin as it was removed piecemeal. Nasal ectopic odontomas are extremely rare, and no prior documentation of an odontoma involving a turbinate was found in the literature. However, a case report involving two nasal floor odontomas with impacted incisors was published in 2003 [
The differential diagnosis includes other odontogenic tumors such as cementomas, ameloblastic odontomas, Pinborg tumors, rhinolithiasis and osteosarcomas [
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