Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 26, 2021; 9(3): 690-696
Published online Jan 26, 2021. doi: 10.12998/wjcc.v9.i3.690
Nasal septal foreign body as a complication of dental root canal therapy: A case report
Xiao-Wan Du, Jun-Bo Zhang, Shui-Fang Xiao
Xiao-Wan Du, Jun-Bo Zhang, Shui-Fang Xiao, Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing 100034, China
Author contributions: Xiao SF was the patient’s surgeon, designed the study, and reviewed the literature; Du XW collected the information, performed the analyses and interpretation of the imaging findings, reviewed the literature, and drafted the manuscript; Zhang JB contributed to data interpretation and manuscript drafting; All authors issued final approval for the version to be submitted.
Informed consent statement: The patient provided informed written consent prior to the submission of the case.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The manuscript was edited according to CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shui-Fang Xiao, MD, Chief Doctor, Professor, Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China. xiao_ent@163.com
Received: October 12, 2020
Peer-review started: October 12, 2020
First decision: October 27, 2020
Revised: November 6, 2020
Accepted: November 29, 2020
Article in press: November 29, 2020
Published online: January 26, 2021
Abstract
BACKGROUND

Currently, there have been no reports on foreign bodies found in the nasal septum after dental root canal therapy. Herein, we present an unusual case of a foreign body found in the nasal septum, which occurred after dental root canal therapy and two unsuccessful surgeries.

CASE SUMMARY

A 55-year-old man was referred to our department due to slight nasal discomfort that persisted for about 1 wk. Before consulting our department, the patient visited three different hospitals/clinics and underwent two surgeries that were not successful in removing a foreign body completely. A computed tomography scan was performed to detect the shift of the foreign body from dental root to the nasal septum, which resulted in the healing of oral inflammation and nasal septum discomfort. An endoscopic foreign body extraction surgery (3rd removal surgery) was then successfully performed, using a needle as the reference. No nasal reconstruction was required after the operation. Postoperative healing was uneventful.

CONCLUSION

Medical healthcare professionals should consider past medical history when dealing with foreign body cases. During septal foreign body extraction surgery, a needle could be used as a helpful reference.

Keywords: Foreign body, Nasal septum, Endodontic complications, Fractured instruments, Case report

Core Tip: In this case report, we present the case of a patient who visited four hospitals/clinics and underwent three surgical procedures for complete removal of a foreign body left during the dental root canal therapy. We consider this case suitable for publication for the following reasons: (1) This is an extremely unusual case. To the best of our knowledge, this is the first report on multiple nasal septal foreign bodies as a complication of dental root canal therapy; (2) It has educational value. This malpractice case calls for integrity reinforcement across medical institutions, as the foreign body left from the dental root canal therapy was deliberately covered up by the dentist until the foreign body broke. The patient visited four different hospitals/clinics and underwent three surgical procedures until the foreign bodies were totally removed; and (3) It has clinical value as it may provide an answer to the following questions: What should a dentist do when surgical instruments fracture? How to tell if there are two segments of a needle or if there is only one needle and the other segment is an artifact? Which surgical approach is the best for the patient?