Abstract

This study aimed to characterize the demographic and clinical features of underreported surgical ciliated cysts developing after sinus floor augmentation, based on a series of cases from our files and a systematic review of the literature. A series of five cases (four patients) of microscopically confirmed surgical ciliated cysts following sinus floor augmentation procedures from our files are described. A systematic literature search (1991–2020) with strict clinical-, radiological- and microscopic-based exclusion and inclusion criteria was performed to detect additional similar cases. The systematic review revealed only five cases that fulfilled the inclusion criteria. Altogether, surgical ciliated cysts associated with sinus floor augmentation have been rarely reported in the literature, and have not been characterized either demographically or clinically. Graft materials were diverse, implants were placed simultaneously, or up to two years post-augmentation. The associated surgical ciliated cysts developed between 0.5 and 10 years post-augmentation. Although limited in its extent, this study is the first series to characterize possible underreported sequelae of surgical ciliated cysts associated with sinus floor augmentation. It emphasizes the need for long post-operative follow-up and confirmation of lesion by microscopic examination.

Highlights

  • Surgical ciliated cysts (SuCCs), or postoperative maxillary cysts, are benign cystic lesions induced after a surgical procedure in the maxillofacial area

  • The systematic review included a total of 581 items, which were screened based on their abstracts and titles

  • According to the prespecified exclusion and inclusion criteria, 567 were excluded since they were either irrelevant or reviews, nine were excluded because of inadequate location, cyst type not specified, surgery procedure not aimed for sinus floor augmentation, or lack of microscopic evaluation of the cystic lesion

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Summary

Introduction

Surgical ciliated cysts (SuCCs), or postoperative maxillary cysts, are benign cystic lesions induced after a surgical procedure in the maxillofacial area. These lesions are associated with a history of radical sinus surgery, orthognathic surgery, and maxillofacial trauma [1,2,3]. The first report of postoperative maxillary cyst after sinus augmentation was made in 1991 [4]. It was proposed that the entrapment of maxillary sinus mucosa during the surgical procedure, followed by an inflammatory process that induces cystic changes of the entrapped respiratory mucosa and expansion of the cyst by the osmotic difference from the surrounding tissue, are the pathogenesis for SuCC formation [6]

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