Epistaxis, nasal obstruction and unilateral facial pain due to an ectopic tooth

Ectopic eruption of teeth within the dentate region of the jaws is frequently noticed in routine clinical practice. However, the ectopic eruption in a non-dentate region is rare, especially in the area of the maxillary sinus. Early surgical intervention for the removal of ectopic teeth along with enucleation of associated cyst, such as a dentigerous cyst, if present, is the preferred treatment. We report a case of a patient who was referred due to chronic mucopurulent discharge and epistaxis, nasal obstruction and unilateral facial pain due to an ectopic third molar. This condition was caused by an ectopic tooth near the sinus ostium; however, the patient had no dental complaints

Bilateral diplopia and abducent nerve palsy secondary to odontogenic sinusitis: an unusual presentation

We present a patient with double vision, photophobia, headache and gait disturbance secondary to odontogenic sinusitis. The initial diagnosis was meningitis; the patient had bilateral diplopia, severe unilateral facial pain, nasal blockage, photophobia, headache and gait disturbance. The patient underwent a septic screening and CT scan of the nose and paranasal sinuses which confirmed unilateral pan-sinusitis. MRI revealed enhancement of bilateral abducent nerves secondary to irritation of the meninges by the opacified sphenoid sinus. The abducent nerve is the first cranial nerve to be affected when the dura is inflamed leading to bilateral diplopia. This unusual presentation led to the initial diagnosis of arachnoiditis. Patient underwent a unilateral full endoscopic sinus surgery and dental extraction of the affected tooth and had a full recovery with intravenous antibiotics and intravenous steroids