上顎前歯部歯槽骨切り術後に両側性に生じたsurgical ciliated cystの1例

Abstract

This case report describes bilateral surgical ciliated cysts that occurred after anterior segmental maxillary osteotomy. A 41-year-old man who had undergone anterior segmental maxillary osteotomy in 1992 was referred to our hospital because of swelling and pain in the left cheek. A panoramic X-ray film and computed tomographic scans showed unilocular and multilocular cystic lesions in the right and left sides of the maxilla; in addition, unilocular cystic lesions including the wisdom tooth crown in the left maxillary tuberosity were seen. The lesions were diagnosed as maxillary cysts and surgically removed with the patient under general anesthesia. Histopathological findings of the walls of the excised cysts revealed that both sides of the premolar region consisted of thick fibrous connective tissue lined with pseudostratified ciliated epithelium. The lesions were diagnosed as surgical ciliated cysts. On the other hand, the wall of the left maxillary tuberosity region consisted of fibrous connective tissue lined with nonkeratinized stratified squamous epithelium. The lesions were diagnosed as dentigerous cysts. The cysts on both sides of the premolar region were located in the osteotomy line of the anterior segmental maxillary osteotomy, suggesting that pseudostratified ciliated epithelium damaged during surgery had migrated from the maxillary sinus into bone pieces and caused the cysts. Long-term follow-up is required after orthognathic surgery of the maxilla to confirm the absence of cysts. The postoperative course was uneventful, and the patient remains free of recurrence 22 months after surgery.