Retrieval-of-displaced-root-fragment-associated-with-fungal-ball-in-the-maxillary-sinus-using-functional-endoscopic-sinus-surgery-a-case-report

Introduction: Fungal ball is a non-invasive sinus disease and the incidence of this disease has increased in recent years and also several case reports and case series have suggested a relationship with the accidental displacement of root into maxillary sinus. We report a case where fungal ball was removed along with the dental root fragment which was accidentally displaced into the maxillary sinus following traumatic dental extraction. A 32-years-oldCase Report: female patient presented to Maxillofacial Surgery Department with complaint of pain in the left orofacial region for one month. The patient had a history of traumatic extraction of posterior maxillary teeth 4 years back. On examination, no dental cause of pain was detected. On further evaluation, a foreign body within the left maxillary sinus was seen in the panoramic radiograph. Computed tomography images revealed displaced root in the left maxillary sinus with surrounding heterogenous soft tissue opacity. Following the detection of foreign body, patient underwent Functional Endoscopic Sinus Surgery (FESS) and the root was retrieved and the adjacent soft tissue specimen was sent for histopathological examination. The presence of fungus consistent with the Aspergillus species was confirmed. Conclusion: This article emphasizes the importance of atraumatic dental extraction, the association of fungal ball with displaced root and the utility of FESS in clearing the same.

Perioperative Management Considerations of Omfs Patients with Diabetes.

Perioperative hyperglycemia is common and associated with increased rates of surgical wound infections, length of hospital stay, morbidity, and mortality. Improved perioperative glycemic control has the potential to improve patient outcome. Surgery and anesthesia induce a stress response with hormonal cascades that influences glucose control. In patients with diabetes and prediabetes, a focused history is necessary to create a plan that optimizes glycemic control in the perioperative setting. The goal of perioperative glycemic control is to keep glucose levels as normal as possible, while avoiding complications associated with hypoglycemia. Metabolic consequences of surgery and preoperative considerations of an inpatient with diabetes are discussed in this paper.