Nonspecific inflammation in the face

Hyun, Young Min; Park, Rae Chung; Jung, Hwan Sug; Choi, Soon Chul; Park, Tae Won; You, Dong Soo

Abstract

Patient with compalints of swelling, pain in the maxillary region and discomfort visited Seoul National University Dental Hospital in August last year. Clinical examination and diagnostic imagings implied he was suffered from fungal h yphal infection but no causative fungus was found by the histopathologic and microbiologic investigation. Therefore he w as diagnosed with nonspecific inflammation. But as yet, we do think this case is very similar to some kinds of mucomycos is. So we presented this case for more thorough discussion. Following are founded in the examination. 1. Patient had sufferd from Diabetes mellitus and complained of stuffness, headache, swelling in buccal cheeks and pare sthesia. And we found more maxillary bony destruction and ulcer with elevated margin in the palate by clinical examinati on. 2. In the first visit, Plain films revealed general bony destruction of the maxilla, radiopaqueness in the sinonasal ca vities. CT and MRI showed soft tissue mass filled in the paranasal sinus except frontal sinus and bony destruction in in volved bones. 3. No causative bacteria and fungus was found in the biopsy and microbiologic cultures. 4. Caldwell-Luc operation and curettage were carried and antibiotics were taken for 4 months. But now he was worse than in the past. 5. In the second visit, involvement of orbit, parapharyngeal sinus, clivus, cavernous sinus and middle cranial fossa we re seen clearly in the CT and MRI.