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Case report
Supernumerary tooth in nasopalatine canal: a rare cause of septal cartilage collapse
  1. Rasads Misirovs1,
  2. Avinash Kumar Kanodia2,
  3. Christopher McDonald3 and
  4. Richard Green1
  1. 1Department of ENT, Ninewells Hospital, Dundee, UK
  2. 2Department of Radiology, Ninewells Hospital, Dundee, UK
  3. 3Head & Neck Surgeon, NHS Grampian, Aberdeen, UK
  1. Correspondence to Dr Avinash Kumar Kanodia; avinash.kanodia{at}nhs.scot

Abstract

Mesiodens is the most common type of supernumerary tooth, located between the maxillary central incisors in close relation to the nasopalatine canal. A 20-year-old man presented with right-sided nasal blockage, nasal discharge and collapsed nose without history of trauma. Imaging revealed a calcified mass in the inferior meatus extending into dilated nasopalatine canal. Endoscopic removal of the mass revealed tuberculate appearance of an incompletely developed tooth, consistent with mesiodens. Based on the history of septal cartilage collapse with right-sided mucopurulent discharge, endoscopic findings of the right inferior turbinate being adherent to the septal cartilage and the underlying mesiodens, we believe that the patient developed a septal abscess secondary to infection in nasal mucosa surrounding the mesiodens causing collapse of septal cartilage. While a tooth or tooth-like mass causing nasal passage air-flow obstruction is uncommon, we believe that this is the first reported case of mesiodens presenting with septal cartilage collapse.

  • ear
  • nose and throat/otolaryngology
  • radiology

https://doi.org/10.1136/bcr-2021-245103

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    Footnotes

    • Contributors All authors (RM, AKK, CM and RG) have made substantial contributions to the conception, design of the work, the acquisition, analysis and interpretation of data; have contributed to drafting the work and revising it critically for intellectual content; have contributed to final approval of the version and are in agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.