Pediatric Infection and Vaccine

The Korean Society of Pediatric Infectious Diseases (대한소아감염학회)
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An Unusual Cause of Acute Maxillary Sinusitis in a 9-year-old Child: Odontogenic Origin of Infected Dentigerous Cyst with Supernumerary Teeth

9세 남자 환아에서 급성 부비동염의 드문 원인 : 과잉치가 동반된 감염된 함기성 낭종

  • Yun, Hye-Won (Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Kwon, Hyuck-Jin (Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Woo, In-Hee (Department of Oral & Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Yang, Byung-eun (Department of Oral & Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Lee, So-Yeon (Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Lee, Hae-Ran (Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Kim, Kwang-Nam (Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine)
  • 윤혜원 (한림대학교 의과대학 소아청소년과) ;
  • 권혁진 (한림대학교 의과대학 소아청소년과) ;
  • 우인희 (한림대학교 치과대학 구강악안면외과) ;
  • 양병은 (한림대학교 치과대학 구강악안면외과) ;
  • 이소연 (한림대학교 의과대학 소아청소년과) ;
  • 이혜란 (한림대학교 의과대학 소아청소년과) ;
  • 김광남 (한림대학교 의과대학 소아청소년과)
  • Received : 2015.07.24
  • Accepted : 2015.09.09
  • Published : 2015.12.25
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Abstract

Acute maxillary sinusitis is a common disorder affecting children. Untreated acute sinusitis can develop into chronic sinusitis, and complications, such as orbital cellulitis or abscess, can occur. Maxillary sinusitis of odontogenic origin is not a well-recognized condition and is frequently missed in children. As an odontogenic source of sinusitis, the dentigerous cyst is one of the most prevalent types of odontogenic cysts, and it is associated with the crown of an unerupted or developing tooth. This report concerns a nine-year-old boy who was diagnosed with maxillary sinusitis originating from a dentigerous cyst with supernumerary teeth. The boy visited our pediatric clinic presenting with rhinorrhea and nasal obstruction and was initially diagnosed with maxillary sinusitis only. With antibiotic treatment, his symptoms seemed to improve, but after 2 months, he came to our clinic with left facial swelling with persistent rhinorrhea and nasal obstruction. Radiographic examinations of the sinuses were performed, and he was diagnosed with maxillary sinusitis originating from a dentigerous cyst with supernumerary teeth. After a surgical procedure involving the removal of the dentigerous cyst with supernumerary teeth, the symptoms of sinusitis gradually diminished. There are only very few cases in the pediatric medical literature that remind us that odontogenic origin can cause maxillary sinusitis in children. Our patient can act as a reminder to general pediatricians to include dentigerous cysts in the differential diagnosis of maxillary sinusitis.

급성 상악동염의 원인으로는 급성 상기도 감염이 가장 흔하며 함치성 낭종 등의 치성원인에 의한 경우는 상악동염의 10-12%를 차지한다. 함치성 낭종은 주로 치과에서 우연한 방사선학적 검사에 의해 발견되며 소아에서는 드물게 보고되고 있다. 함치성 낭종이 과잉치와 동반되었을 때 주위 상악골의 파괴와 치근의 흡수를 야기하거나 침범된 치아의 변위를 유발할 수 있으므로, 조기 진단과 적절한 치료가 중요하다. 본 증례에서 콧물과 코막힘으로 부비동염으로 진단받았던 9세 남자 환아가 2개월 뒤 좌측안면부 연부조직염으로 내원하여 시행한 방사선학적 검사에서 좌측 상악동에 과잉치와 동반된 함기성 낭종이 관찰되었으며, 치료로 외과적 절제술을 시행하였다. 저자들은 소아에서 부비동염의 원인으로 과잉치를 동반한 감염된 함치성 낭종을 경험하였으며, 부비동염의 진단과 치료에 있어 항생제 치료로 호전되지 않거나 증상이 지속될 시 단순 상기도감염 합병증 외에 다른 질환의 감별을 고려할 것을 당부하는 바이다.

Keywords

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