We are located in Aarhus. The year is 2017. A random 59-year-old man notices the irritation in his left nostril. It seems clogged, and the sense of smell is impaired.
After two years of various treatment trials seek he finally Ear-Nose-Halsafdelingen at Aarhus university Hospital.
Here is Jesper Højager Fabech Bille, clinical associate professor and ear, nose and throat doctor at the university hospital, ready to accept the patient, he explains in an article on Science.dk.
He make as the first one kikkertundersøgelse – a normal initial procedure in such a case.
It is clear to see that something looks wrong, explains Jesper Højager Fabech Beetle. The next natural step is, therefore, a CT-scan.
the Patient put themselves right in the scanner, and the head run into the big white donut of a device that beeps, spins, and flashes.
scanning images revealed the precise cause of the suffering: A tooth on the balance was grown deep up into the man’s nose.
– After the scan, we could see the tooth, and in the picture you can even see the root canal in the tooth. The sat further up than a finger has been unable to row, says Jesper Højager Fabech Beetle to an article on Science.dk, where you can also see skanningsbilledet.
The strange discovery is published in the medical journal BMJ Case Reports. Milos Fuglsang, ear-nose-throat-doctor at Aarhus university Hospital, and Marie Louise Mills, kontorfunktionær at Aarhus university Hospital, are co-authors.
– Not something I had even seen before.
the Tooth is the size of the tip of a pen, and it has probably been sitting in the næseregionen on the man most of his 59-year life.
– You may have a clogged nose for many reasons, and this was a rare cause. It was not something I had even seen before, says Jesper Højager Fabech Beetle.
And what do you do as a surgeon?
– Then digs in his surgical experience and considering what can happen when you pill it out. We were, for example, a particular attention, you may risk a hole in the palate, when to pill the tooth out, he says.
When they finally got the tooth out, was it sent over the hospital’s pathologists, before the 100 per cent security could turn the found real.
Must have been congenital
It is hard to say how and why the tooth exactly is ended up in the left nostril on the 59-year-old man. Jesper Højager Fabech Beetle and his colleagues also conclude in their article that “there was no obvious explanations”.
the Man had ansigtsskader, from when he was younger, and both his jaw and nose had been broken, but the doctors do not believe that it could be the reason, they write.
– It must have been congenital, and something that happened in a stage of development. In it that the teeth grow forward, it may be that the front teeth have not fallen out, and so the settling of the tripod, the other teeth, so it may be that it still had baby teeth, he had, explains Jesper Højager Fabech Beetle.
He turns at the same time real, that the man was never in danger.
– It is not dangerous. The symptoms, you need to be aware of here, is that if you are experiencing bleeding, it could for example be a symptom of cancer, he explains.
23 cases are reported worldwide
according to the article only reported 23 similar cases worldwide.
the Phenomenon is, not so surprisingly, quite rare, and the doctors estimate also in the article, that it may be found in about 0.1 to 1 percent of the world’s population.
Christian von Buchwald, md clinical professor of Ear-nose-halskirurgisk Clinic at the Hovedortocentret at Rigshospitalet in copenhagen, who was not involved in the operation in Aarhus, concedes opposite of Science.dk, that “it is a rare condition”.
But he calls at the same time fixed, to the number of cases with high security is higher than the 23 cases reported in the article.
Christian von Buchwald has even operated one out no later than a year ago in 2018, and have also tried it a handful of times in the past, but he never reported it to a journal.
Can serve as the experience
Jesper Højager Fabech Beetle, has, with the newest article included, since 2015 sent 4 different surgical cases to BMJ Case Reports.
– When one finds something as rare as it is here, as worldwide only seen a few times, so it’s about to share it, so your colleagues can see, how to treat it here, if they should encounter it, he explains.
He acknowledges at the same time, that the articles is not so-the research relevant.
– It is one case, and one can not carry out clinical trials, where you have ten people with teeth in the nose, because it is so rare, says Jesper Højager Fabech Beetle.
A ‘good story’
Christian von Buchwald has, as mentioned, not shared it in the journals, when he as a surgeon is encountered on a tooth, as he has been with to operate away from the nose.
It is because he believes that it does not have much medical value.
– It is not something special beyond a ‘good story’, says Christian von Buchwald.
If it is something big and important, so it was come in one of the big journals as The Lancet, The beats he also.
He believes that the story can only be used to consider the differential diagnoses, which is a secondary hypothesis of a diagnosis, but in addition, he believes that it is most interesting for the patient himself.
– the History of the magazine can make one aware that it is a phenomenon that exists. But it’s not something you as a patient or doctor must go and think on the daily, assesses Christian von Buchwald opposite of Science.dk.
for example, You can read about a man who had so much fat in his blood that it was white as milk.
Or, you can read about a british woman who returned from vacation with the larva in the forehead.
If that doesn’t catch your interest, then there is also the story of the woman who got rid of a 27 kg heavy tumor from the uterus.
