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Odontogenic Keratocyst Invading Sphenoid Sinus
Christian Bötel, Julian Lommen, Norbert R Kübler and Henrik Holtmann*
Department of Oral and Maxillofacial Surgery, University Clinic of Düsseldorf, Germany
*Corresponding author: Henrik Holtmann, Department of Oral and Maxillofacial Surgery, University Clinic of Düsseldorf, Germany
Published: 27 Jul, 2018
Cite this article as: Bötel C, Lommen J, Kübler NR,
Holtmann H. Odontogenic Keratocyst
Invading Sphenoid Sinus. Clin Surg.
2018; 3: 2052.
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A 15-year-old patient was referred to our clinic with a swelling and intermittent pain of the right
cheek and a severely displaced right upper wisdom tooth as an incidental finding on a routine dental
panoramic radiograph showed. Clinical examination revealed a distended right maxillary sinus and
pain on palpation in the region.
Further imaging consisting of an MRI and a CT scan (Figure 1) showed a large cystic lesion
occupying the complete right maxillary sinus, extending well into the right sphenoid sinus. The
accompanying right upper wisdom tooth was also discernible in the right sphenoid sinus.
In preparation for the operation, we fused the MRI and CT scan (Figure 2 and 3) and planned
the brainlab-navigated removal of the lesion and the associated wisdom tooth. The removal was
performed transoraly and transnasaly as enucleation with peripheral
ostectomy. The histopathological examination of the specimen
revealed the unexpected diagnosis of an odontogenic keraticyst in
this unusual location. Up to know (1½ years) the patient remains
without recurrence shown by actual CT scans.
Figure 1
Figure 1
Coronary CT scan with a soft tissue mass filling the whole right maxillary sinus (circle) and
communicating third upper molar displaced into the right sphenoidal sinus (bolt).
Figure 2
Figure 2
Matched CT and MRI scan marking the whole mass within the right maxillary sinus (a coronary, b
sagittal slide).