Full Mouth Rehabilitation in a Rare Case of Situs Inversus

What is it about?

Situs inversus totalis (SIT) has been reported as a rare entity. SIT is inherited as an autosomal recessive pattern and is associated with multiple gene mutations. Situs inversus totalis is a condition that is characterized by abnormal positioning of the heart and other internal organs. It may or may not be associated with other congenital defects. Diagnosis of situs inversus totalis is an important in a patient who does not have any congenital anomalies, which may indicate a normal life expectancy, the patients presentation of common ailments may become difficult to diagnose due to mirrored anatomy. Here we report the full mouth rehabilitation in a case of situs inversus totalis.

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Photo by Robina Weermeijer on Unsplash

Photo by Robina Weermeijer on Unsplash

Why is it important?

Dextrocardia is an abnormal positioning of the heart on the right side of the chest instead of the left. A condition in which dextrocardia is associated with a reversal in the position of other organs is known as situs inversus totalis. Situs inversus totalis (SIT) is defined as a mirror image reversal of all the asymmetric structures of the thorax and abdomen. Situs inversus totalis has only occurred in a few cases and its incidence is about 1:10,000 live people. Generally, many individuals with SIT are unaware of their unusual anatomy. Situs inversus totalis is often diagnosed while medically assessing other conditions. Diagnostic modalities include chest radiograph, electrocardiogram, echocardiography, and magnetic resonance imaging. Generally, the condition is asymptomatic unless not associated with congenital heart defects. Great vessels transposition is seen in 5 to 10% of cases and is the most commonly occurring defect . In addition, dextrocardia with a normal abdominal situs has a higher incidence (90-95%) of associated congenital cardiac anomalies including transposition of the great vessels, Atrial septal defects (ASDs), and ventricular septal defect (VSDs). Comparatively, dextrocardia with situs inversus is associated with a lower incidence (0 to 10%) of congenital heart disease. Other associated congenital anomalies may include duodenal atresia, asplenism, multiple spleens, ectopic kidney, horseshoe kidney, and various pulmonary and vascular abnormalities. The life expectancy of individuals with situs inversus without other congenital anomalies is normal. The risk of acquiring the disease is similar to the same age and sex of other persons. Life expectancy is reduced based on the severity of the defect with cardiac anomalies. However, to prevent mishaps during surgery, recognition of situs inversus is important.

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