Endoscopic removal of a rare ectopic tooth root in the ethmoid sinus: a case report

Background: Eruption of an ectopic tooth root within the sinonasal region is an uncommon phenomenon, most frequently reported in the maxillary sinus and nasal cavity. An ectopic tooth root within the ethmoid sinus is exceedingly rare, with only a few cases documented in the literature, often associated with prior trauma or iatrogenic displacement. Case presentation: A 45-year-old male with a history of hypertension and diabetes mellitus presented with a 2-year history of unilateral nasal obstruction, postnasal drip, and intermittent frontal headaches. Physical examination revealed hypertrophy of the left inferior turbinate. Paranasal sinus computed tomography demonstrated left maxillary sinusitis and a dense, sclerotic lesion within the left ethmoid sinus, initially interpreted as an osteoma. The patient underwent functional endoscopic sinus surgery. Histopathological examination of the excised lesion confirmed the diagnosis of an ectopic tooth root, identifying a tooth root fragment containing dentin and pulp tissue, associated with chronic mucosal inflammation. The patient reported no history of facial trauma or dental procedures in the region. Conclusion: This report presents a rare case of a primary, idiopathic ectopic tooth root located within the ethmoidal sinus of an adult. It emphasizes the importance of including this condition in the differential diagnosis of paranasal sinus masses and highlights the essential role of histopathological examination for definitive diagnosis. The idiopathic nature of this case underscores the underexplored and likely multifactorial pathogenesis of ectopic tooth root development in atypical locations, warranting further investigation.