Article Text
Summary
We present a case of a 59-year-old man with left upper alveolar numbness of 2 years’ duration in the absence of sinonasal symptoms. On physical examination, he demonstrated mild left facial asymmetry and diminished sensation of his left upper alveolus from the left second upper incisor to first canine. CT imaging revealed chronic sinusitis changes of the left maxillary sinus, with reduced volume and depressed anterior wall. The patient underwent functional endoscopic sinus surgery to re-establish maxillary sinus ventilation. He was noted to have some improvement of his upper alveolar paraesthesia postoperatively. Silent sinus syndrome is part of the spectrum of chronic maxillary atelectasis. In the presented case, chronic osteitic bony sclerosis, as opposed to osteopenic change of the maxillary sinus, was seen. We postulate that bony encasement of the anterior superior alveolar nerve resulted in chronic nerve compression and the patient’s unusual symptom of upper alveolar paraesthesia.
- Ear, nose and throat/otolaryngology
- Otolaryngology/ENT
- Surgery
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Footnotes
Contributors According to the definition given by the International Committee of Medical Journal Editors (ICMJE), the authors have made one or more of the substantial contributions to the intellectual content as follows:
conception or design of the work: HTL, KHL.
Data collection: HTL, KHL.
Data analysis and interpretation: HTL.
Drafting the article: HTL.
Critical revision of the article: KHL.
Final approval of the version to be published: HTL, KHL.
Competing interests None declared.
Patient consent Not obtained.
Provenance and peer review Not commissioned; externally peer reviewed.