Surgical treatment of unusual osteoma associated with homolateral radicular cyst of the maxillary sinus

Elena Cantone,Antonella Miriam Di Lullo,Maurizio Iengo,Michele Cavaliere,Antonio Romano,Giulia Foschi,Aldo Torrisi,Antonia Cama,Luigi Califano,Sergio Motta

doi:10.1051/mbcb/2020022

Abstract

Introduction: We described a rare clinical case of osteoma associated with homolateral radicular cyst of the maxillary sinus. Observation: Imaging showed two different lesions in the right maxillary sinus. We performed a combined surgical approach to completely remove the lesions and used a plasma rich in growth factors membrane to repair dental roots. No relapse after a 2 years follow-up was observed. Commentaries: The simultaneous presence of two large lesions, a 23,7 mm osteoma and a 33,7 mm radicular cyst in the same maxillary sinus, has been rarely described in the literature. Although nasal endoscopy and imaging are mandatory to assess the diagnosis, the definitive diagnosis was obtained after histopathologic examination. A combined surgical approach allowed a complete removal of both lesions, ensuring, at same time, an optimal surgical field. Plasma rich in growth factors membrane due to its cohesive properties was particularly useful in improving bone neoformation and periodontal regeneration. Conclusion: Diagnostic assessment of maxillary lesions requires nasal endoscopy, imaging and histopathological examination. If these lesions are symptomatic, they should be completely removed and minimally invasive surgery is indicated. Plasma rich in growth factors membrane ensures a good postoperative recovery.

Highlights

A forty-one-year-old female came to our hospital complaining right sided nasal respiratory obstruction, homolateral mucopurulent rhinorrhea, epiphora, auricular fullness and cacosmia for about 6 months, without history of chronic rhinosinusitis, significant family, social or medical history apart from previous not well described dentistry treatments and a rhinoseptoplasty 11 years earlier
The imaging showed the obstruction of the right natural maxillary ostium by the cyst, that in association with the osteoma caused sino-nasal dis-ventilation and consequent rhinosinusal inflammation (Fig. 1)
We found a communication with the maxillary sinus due to the osteolysis generated by the cyst

Summary

Introduction

A forty-one-year-old female came to our hospital complaining right sided nasal respiratory obstruction, homolateral mucopurulent rhinorrhea, epiphora, auricular fullness and cacosmia for about 6 months, without history of chronic rhinosinusitis, significant family, social or medical history apart from previous not well described dentistry treatments and a rhinoseptoplasty 11 years earlier. Nasal endoscopy showed a medialization of the right lateral wall and a lift of the floor with mucosal hyperemia and abundant ipsilateral mucopurulent discharge. Computed tomography (CT) showed the presence of two lesions in the right maxillary sinus: the first, 23.7 mm in the

Results

Conclusion