An Unusual Case of Sinusitis in a Flight Attendant

TL;DR

A flight attendant developed sinusitis from a dental foreign body that migrated during air travel, highlighting a rare medical case.

Contribution

This case report highlights a unique instance of foreign body sinusitis linked to a dental procedure and occupational barotrauma.

Findings

A dental amalgam migrated from the maxilla to the ethmoid infundibulum, causing sinusitis.

Non-operative management failed, requiring surgical removal of the foreign body.

The patient's recovery was successful after the foreign body was removed.

Abstract

Foreign body sinusitis is a rare but important condition that should be taken into account when considering differential diagnoses. In this case report, we present a unique case of sinusitis caused by a foreign body originating from a dental procedure. Additionally, the complexity of the case was compounded by the patient's occupation as a flight attendant. A 49-year-old female flight attendant presented with a two-month history of facial pressure exacerbated by flying. A computed tomography (CT) of her paranasal sinuses confirmed the presence of a radiopaque foreign body near the left maxillary infundibulum, with minimal left ethmoid sinus mucosal thickening. Initially, she elected for non-operative management due to schedule conflicts. Upon follow-up over the next year, she complains of recurring severe facial swelling and congestion. A repeat CT scan shows that she has a dental amalgam that migrated from her left maxilla to the ethmoid infundibulum, lodged between her uncinate process and ethmoid bulla. The patient subsequently underwent foreign body removal. The patient recovered well, and a follow-up CT confirmed the complete removal of the foreign body. This case provides excellent insight into the mechanism of foreign body migration and sinusitis complicated by the unique circumstances of barotrauma associated with regular air travel.

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