A conservative approach to Aspergillus sinusitis

Abstract

The aim of the case report was to present a new case of Aspergillus sinusitis with a conservative approach without apicoectomy. A twenty-two-year-old healthy female patient was presented. Unilaterally, the dense radiopacity of the maxillary sinus was detected in the dental examination. Radiopaque deposits within the right maxillary sinus, associated with the endodontically treated tooth #16 were monitored with the cone-beam computerized tomography taken as a diagnostic aid. Retreatment with surgery was planned. Following the chemomechanical preparation, orthograde calcium silicate cement (OrthoMTA, BioMTA Co., Seoul, Korea) was grafted into root canals prior to the surgery. The pathologic tissue adjacent to palatal root apices of tooth #16 located in the inferolateral wall of the right maxillary sinus floor was reached in Cadwell-Luc operation. The pathologic tissue was excised and root apices were not resected. Microscopically examination of the material revealed hyphae structures compatible with Aspergillus and furthermore, Aspergillus spp. was grown in microbiological culture. The definitive diagnosis was made as maxillary sinus aspergilloma according to the existing clinical, radiological and microbiological findings. No systemic antifungal treatment was performed in the postoperative period. The tooth has been followed up to 2 years. The asymptomatic clinical condition was maintained and radiographic healing was observed.