Abstract
The postoperative maxillary cyst develops as a delayed complication many years after radical operation on the maxillary sinus to relieve chronic sinusitis. Trapping of the mucosa of the maxillary sinus in the wound and closure of the nasoantral window made beneath the inferior turbinate before filling of the postoperative bony cavity by regenerated granulation tissue are believed to be most responsible for the development of this cyst. Although reports of the cyst are extremely rare in the English literature, it has constituted more than 20% of jaw cysts in Japan. However, the incidence has decreased to 16% to 17% because of the decrease in chronic maxillary sinusitis and the surgical intervention for treatment of the disease. The cyst occurs more often in men than in women, developing in the fourth and fifth decades 10 to 30 years after radical sinus surgery. The most common symptoms are swelling and pain in the cheek and the mucogingival fold. Radiographically, the cysts appear as unilocular or multilocular, well-defined, cystic radiolucencies in the region of the maxillary sinus. CT is quite useful in clarifying the number, size, location, and shape of the cysts, as well as bony perforation and involvement of tooth apices. A Caldwell-Luc type of operation is usually performed for the treatment of these cysts. A small cyst can be treated by enucleation and primary closure or enucleation and open packing. Marsupialization is also used for large cysts with extensive bony perforation. In most cases, the cysts have a relatively thin cyst wall and contain brown, mucinous fluid. The prognosis is good, but recurrence is encountered in a limited number of cases. Histologically, the lining is mainly ciliated columnar epithelium, but transition to columnar, cuboidal, and squamous epithelia is often observed, even in a single cyst.
Published Version
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