鼻前庭に生じた外歯瘻の1例

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  • A case of external dental fistula arising in the nasal vestibule
  • ビ ゼンテイ ニ ショウジタ ガイシロウ ノ 1レイ

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External dental fistula originating from the maxilla mainly occurs at the alar base in the anterior tooth region and at the buccal region in the posterior tooth region. We describe a patient with a fistula at the nasal vestibule. The patient was a 50-year-old woman who had tenderness and swelling from the right nasal vestibule to the alar base. A dome-shaped nodular erythema of 3 mm in diameter was found at the nasal vestibule. The probe was guided toward the apex of the upper lateral incisor. A CT scan showed periapical trabecular bone loss at the upper lateral incisor, uniform radiolucency, and thinning of cortical bone on the labial aspect with partial loss of continuity. The lesion was adjacent to the nasal cavity floor. Surgery was performed for a diagnosis of radicular granuloma at the upper lateral incisor and external fistulation at the nasal vestibule. Below the piriform aperture, a white fibrous restiform structure 3 mm in diameter and 10 mm long extended from the apical lesion to the nasal vestibule. The suppurative inflammation at the apical lesion was blocked by the muscularis depressor septi and the muscularis nasalis but extended upward, resulting in a fistulation at the nasal vestibule.

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