Author(s)
Andrea K. Nguyen, BS
Rahul M. Varman, MD
Winslo Idicula, MD
Affiliation(s)
Texas Tech University Health Sciences Center;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to discuss this unique presentation of ectopic tooth in the orbital cavity.
Objectives: Gunshot wounds to the head are often fatal and self-inflicted injuries have a high mortality rate. As a result, these cases are often not seen or treated. Foreign objects in the orbital canal can lead to vision loss and be a source of infection, however surgical extraction must be approached cautiously to preserve function of ocular nerves and muscles. The purpose of this report is to describe an unusual case in which a molar was embedded in the orbital floor following a self-inflicted gunshot wound.
Study Design: Descriptive study of a patient case, from presentation to resolution.
Methods: Case report and literature review.
Results: A 28 year old male was seen by ENT after he shot himself in his right lower jaw. CT scan reports fractures of the midface and mandible along with foreign body lodged into his left orbital floor. Tooth was successfully extracted through the incision of the periosteum over the orbital rim without damage to the eye. One year after the procedure, the patient noticed swelling with drainage underneath his left eye. Culture showed streptococcus constellatus, a microorganism commonly found in the mouth. Patient was improved after course of antibiotics.
Conclusions: This case is remarkable for the presence of an ectopic tooth in the orbital cavity as well as possible seeding of odontogenic organisms causing an infraorbital abscess. While there have been published reports of ectopic teeth that naturally erupted into the orbital floor, there is very little data on teeth in the orbital cavity as the result of trauma.