Bleach-Induced Chemical Sinusitis and Orbital Cellulitis Following Root Canal Treatment
The authors describe an unusual case of chemical sinusitis and orbital cellulitis secondary to a sodium hypochlorite accident in a patient who had just undergone root canal treatment. The patient presented with acute, progressive symptoms of unilateral maxillary sinusitis, facial cellulitis and orbi...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-05-01
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| Series: | Sinusitis |
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| Online Access: | https://www.mdpi.com/2673-351X/7/1/2 |
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| author | Terese Huiying Low Jun Jie Seah Somasundaram Subramaniam Vijayaraj Thirunavukarasu Chew Lip Ng |
| author_facet | Terese Huiying Low Jun Jie Seah Somasundaram Subramaniam Vijayaraj Thirunavukarasu Chew Lip Ng |
| author_sort | Terese Huiying Low |
| collection | DOAJ |
| description | The authors describe an unusual case of chemical sinusitis and orbital cellulitis secondary to a sodium hypochlorite accident in a patient who had just undergone root canal treatment. The patient presented with acute, progressive symptoms of unilateral maxillary sinusitis, facial cellulitis and orbital cellulitis which began hours after root canal treatment on the ipsilateral side. He was admitted to hospital under the care of the Otorhinolaryngology team and reviewed regularly by the Ophthalmologists. He underwent Endoscopic Sinus Surgery during his hospital stay. The intraoperative findings revealed necrotic sinus mucosa and slough within the involved maxillary sinus, which were suggestive of chemical burn injury induced by the highly alkaline sodium hypochlorite solution used during root canal treatment. He was treated postoperatively with regular nasal toilet, culture-directed antibiotics and topical ocular pressure-lowering eyedrops. He displayed a slow recovery with eventually no orbital sequelae, but experienced persistent cheek numbness three months post-injury. Severe chemical sinusitis with orbital cellulitis secondary to sodium hypochlorite accident is a rare complication of root canal treatment, with potentially severe consequences. It can present with symptoms similar to complicated acute bacterial sinusitis. Otorhinolaryngologists and dental surgeons should maintain a high index of suspicion when managing a patient post-root canal treatment with symptoms of unilateral sinusitis, facial cellulitis, orbital cellulitis and even airway compromise. This would allow prompt intervention before sight or life-threatening complications set in. |
| first_indexed | 2024-03-11T01:56:10Z |
| format | Article |
| id | doaj.art-9f480d001e8140d399900f7f08351ab1 |
| institution | Directory Open Access Journal |
| issn | 2673-351X |
| language | English |
| last_indexed | 2024-03-11T01:56:10Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Sinusitis |
| spelling | doaj.art-9f480d001e8140d399900f7f08351ab12023-11-18T12:36:49ZengMDPI AGSinusitis2673-351X2023-05-017161110.3390/sinusitis7010002Bleach-Induced Chemical Sinusitis and Orbital Cellulitis Following Root Canal TreatmentTerese Huiying Low0Jun Jie Seah1Somasundaram Subramaniam2Vijayaraj Thirunavukarasu3Chew Lip Ng4Department of Otolaryngology—Head and Neck Surgery, Ng Teng Fong General Hospital, National University Health System, Singapore 609606, SingaporeDepartment of Otolaryngology—Head and Neck Surgery, Ng Teng Fong General Hospital, National University Health System, Singapore 609606, SingaporeDepartment of Otolaryngology—Head and Neck Surgery, Ng Teng Fong General Hospital, National University Health System, Singapore 609606, SingaporeDepartment of Otolaryngology—Head and Neck Surgery, Ng Teng Fong General Hospital, National University Health System, Singapore 609606, SingaporeDepartment of Otolaryngology—Head and Neck Surgery, Ng Teng Fong General Hospital, National University Health System, Singapore 609606, SingaporeThe authors describe an unusual case of chemical sinusitis and orbital cellulitis secondary to a sodium hypochlorite accident in a patient who had just undergone root canal treatment. The patient presented with acute, progressive symptoms of unilateral maxillary sinusitis, facial cellulitis and orbital cellulitis which began hours after root canal treatment on the ipsilateral side. He was admitted to hospital under the care of the Otorhinolaryngology team and reviewed regularly by the Ophthalmologists. He underwent Endoscopic Sinus Surgery during his hospital stay. The intraoperative findings revealed necrotic sinus mucosa and slough within the involved maxillary sinus, which were suggestive of chemical burn injury induced by the highly alkaline sodium hypochlorite solution used during root canal treatment. He was treated postoperatively with regular nasal toilet, culture-directed antibiotics and topical ocular pressure-lowering eyedrops. He displayed a slow recovery with eventually no orbital sequelae, but experienced persistent cheek numbness three months post-injury. Severe chemical sinusitis with orbital cellulitis secondary to sodium hypochlorite accident is a rare complication of root canal treatment, with potentially severe consequences. It can present with symptoms similar to complicated acute bacterial sinusitis. Otorhinolaryngologists and dental surgeons should maintain a high index of suspicion when managing a patient post-root canal treatment with symptoms of unilateral sinusitis, facial cellulitis, orbital cellulitis and even airway compromise. This would allow prompt intervention before sight or life-threatening complications set in.https://www.mdpi.com/2673-351X/7/1/2chemical sinusitisbleachhypochloritedentalroot canalorbital cellulitis |
| spellingShingle | Terese Huiying Low Jun Jie Seah Somasundaram Subramaniam Vijayaraj Thirunavukarasu Chew Lip Ng Bleach-Induced Chemical Sinusitis and Orbital Cellulitis Following Root Canal Treatment Sinusitis chemical sinusitis bleach hypochlorite dental root canal orbital cellulitis |
| title | Bleach-Induced Chemical Sinusitis and Orbital Cellulitis Following Root Canal Treatment |
| title_full | Bleach-Induced Chemical Sinusitis and Orbital Cellulitis Following Root Canal Treatment |
| title_fullStr | Bleach-Induced Chemical Sinusitis and Orbital Cellulitis Following Root Canal Treatment |
| title_full_unstemmed | Bleach-Induced Chemical Sinusitis and Orbital Cellulitis Following Root Canal Treatment |
| title_short | Bleach-Induced Chemical Sinusitis and Orbital Cellulitis Following Root Canal Treatment |
| title_sort | bleach induced chemical sinusitis and orbital cellulitis following root canal treatment |
| topic | chemical sinusitis bleach hypochlorite dental root canal orbital cellulitis |
| url | https://www.mdpi.com/2673-351X/7/1/2 |
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