Intraoral Herniation of a Sinonasal Polyp: An Underreported Complication of Maxillary Extraction?

Purpose: The aim of the present study was to increase awareness of an underreported surgical complication by presenting the relevant findings of cases of herniated oroantral sinonasal polyp (OASNP) identified from our biopsy service and from previously reported cases.

Materials And Methods: The present study was a retrospective descriptive case series with a review of the reported data. Cases of OASNP were identified from our biopsy service, and the clinical, radiographic, surgical, and demographic information was retrieved. Previously reported cases of OASNP were also reviewed.

Results: We identified 14 cases of OASNP in our biopsy service and an additional 10 reported cases. Overall, OASNP was more prevalent in males (71%). The age range was 19 to 85 years (overall mean, 46.6 years; median, 43.5 years). OASNP typically presented as a red polypoid mass that was frequently pedunculated with a smooth or granular surface. The lesions were located on the maxillary alveolus in the molar region. The most commonly implicated tooth was a maxillary first molar (74%). In some cases, the OASNP had been mistaken for a tumor or pyogenic granuloma. Almost all were at least 1 cm in the greatest dimension, with 43% measuring at least 2 cm in size, and 1 lesion reaching 5 cm in diameter. The reported period for development of the lesion ranged from 2 days to 5 years, with 60% developing within 2 months of the extraction. All lesions had undergone surgical excision. Antibiotic use and surgical closure of the oroantral communication had been described for some of the cases.

Conclusions: The results from our study suggest that herniation of a sinonasal polyp through an oroantral defect could be an underreported complication of maxillary exodontia. Additional research would help to enhance our knowledge and understanding of this interesting condition.