Rare Case: Wisdom Tooth Grows Under Patient's Eye|少女智齒長眼框下 囊腫壓迫嚴重恐失明

An 18-year old woman went to the hospital for acute cellulitis, and the doctors found that she has a wisdom tooth growing below her left eye, close to the bridge of her nose, and it's causing a growing cyst that is close to her eye socket. Doctor is worried that the growing wisdom tooth could add pressure to her eye and might cause her to lose vision. It took more than a year to gradually remove the tooth. This is the first documented case of a wisdom tooth growing beneath a person's eye socket. The reason behind the odd position cannot yet be determined.


A wisdom tooth is growing close to the bridge of the nose, just one centimeter away from the patient's left eye. The doctor is quite surprised when he saw the X-Ray photo and found that the wisdom tooth isn't growing at a normal position. The tooth has caused a cyst which led to acute cellulitis. Lulu, the 18-year old patient was preparing for her university entrance exam, and had no idea of how serious her condition was.

I felt my teeth swelling when I eat, and there's tissue fluid (in my mouth).

The tooth is too close to her eye and has caused an acute cellulitis. The doctors didn't risk removing the tooth when they first found it. However, Lulu's parents were quite concerned.

The wound has festered, and it's causing an acute cellulitis. The X-Ray photo shows a sizeable cyst. We think it's very strange.

The doctors said that the wisdom tooth that doesn't grow at its usual place has caused tooth impaction. However, there has never been a documented case in Taiwan in which a patient has a wisdom tooth right below one's eyes. There have been a few similar cases from other countries. The position of the tooth is very tricky and dangerous, and mistake in the attempt to remove it could damage the patient's eyesight. The treatment lasted for more than a year.

The position of the wisdom tooth is very abnormal. It's below the patient's eye socket and right next to the bridge of her nose. It has caused a large sized cyst. In the first phase of the treatment, we're hoping to reduce the size of the cyst. We have resorted to what is called marsupialization to try to move the cyst away from the tooth.

The doctors said the cause of the condition is unclear. They are hoping to publish the case files and gather as much expertise as possible. The doctors also remind the public that the best time to treat tooth impaction is between 15 and 19 of age, because the symptom has the least chance of causing complications. The doctors say that 17 percent to 26 percent of these cases cause cyst, and those who suffer from similar symptoms should seek medical attention immediately in order to not miss the best time for treatment.



智齒長在鼻樑正中央，與左眼框骨距離1公分左右，醫師看到X光片後大吃一驚，患者的智齒沒有長在齒列上，卻長在這樣的位置上，而且囊腫已經引發蜂窩性組織炎。18歲的嚕嚕，正值考大學的時刻，一開始還不知道問題的嚴重性，只覺得疼痛。

阻生齒患者 嚕嚕表示：「吃東西的時候，發現牙齦腫起來，然後會有分泌體液(組織液)。」

由於太靠近眼睛，又已經囊腫化膿，醫師也不敢一開始就摘除智齒，但嚕嚕的父母親聽到後，非常擔心。

嚕嚕的父親表示：「那個化膿的稍微已經有一點，要轉變成蜂窩性組織炎，照出來發現囊腫已經長那麼大了，覺得喔，太奇怪了！」

醫師指出，沒有長在齒列上，就叫做"阻生齒"，但長在眼眶骨與鼻骨正下方，查遍國內文獻資料尚未發現相關案例，國外雖然有相關案例，但也不多見，也因為部位敏感又危險，稍有不慎怕傷及眼睛視力，整個治療過程長達一年多。

口腔顎面外科醫師 蘇竣揚表示：「我們的鼻子的旁邊，以及在我們眼眶的正下方，所以這個智齒的位置，相當相當的特別，而且它合併有一個巨大的囊腫，階段性的治療第一個階段，我們是希望那個囊腫能夠縮小，並且我們那個智齒，看能不能夠盡量往外移動，那這個方式我們是使用，所謂的造袋術。」

醫師指出，這個案例發生原因不明，透過案例的發表，希望能集思廣益，也提醒民眾，阻生智齒最適合拔除的年齡在15~19歲間，併發症相對較少，17%~26%會合併囊腫形成，一旦發生這的情況，盡速就醫，避免延誤病情。