Maxillary Sinus Cyst Research Articles

Сравнительный анализ состава метаболитов тканей кист различных систем жизнеобеспечения методом ТГц спектроскопии высокого разрешения

The work is devoted to the study of the chemical composition of tissue metabolites for the organs of the ear, throat and nose and various life support systems by high-resolution THz spectroscopy on the example of samples of relatively healthy mucous membranes and cysts of the paranasal sinuses, as well as the shell of the renal cyst and median cyst of the neck. A high-resolution THz spectrometer with phase manipulation developed by the authors, operating in the 115-178 GHz range, was used. The chemical compounds were identified by absorption lines using electronic databases. Rotational absorption lines of alcohols, nitriles and organosulfur compounds are detected both in the spectra of samples of relatively healthy mucous membranes and in the spectra of cystic tissues. However, in the spectra of a relatively healthy mucous membrane, the number of absorption lines of some of these chemicals is less than in the spectra of cysts, which indicates their lower concentration. In addition, during thermolysis of cystic tissue samples, substances such as ketones, organic acids, aldehydes, and nitriles are formed, which can be considered as potential biomarkers of the pathological state of the tissue. A comparative analysis of the spectra of the maxillary sinus cyst, the shell of the kidney cyst and the median cyst of the neck showed that they are similar with minor differences. Identification of similar substances in tissues with the same pathology, but in different life support systems of the body, may be the first step towards determining the metabolic profile of this pathology as a whole. Thus, the potential possibility of using high-resolution THz spectroscopy to analyze the metabolic composition of tissues of various life support systems is shown.

Bone resorption marker RANKL in the diagnosis and treatment of patients with maxillary sinus cysts

Background. RANKL (Receptor Activator of Nuclear Factor Kappa-B Ligand) is a protein belonging to the tumor necrosis factor superfamily serving as a specific marker for osteoclast activation and osteolysis. Aim. To determine RANKL levels in the homogenates of Maxillary Sinus Cysts (MSC) at the time of their removal, investigate the correlation of these indicators with the presence of pathology in the upper row of projection teeth in the respective patients, and refine the timing for potential dental implantation or sinus lifting after sinusotomy based on these findings. Materials & Methods. The study included 25 patients aged 20–65 years who underwent surgical treatment for MSCs located on the inferior wall of the sinus. The research methods comprised general clinical, otorhinolaryngological, radiological, and pathohistological techniques and Enzyme-Linked ImmunoSorbent Assay (ELISA) for RANKL in the tissues of the removed cysts. Pathohistological examination revealed retention cysts in 11 patients and pseudocysts in 14 patients. The presence of dental pathology and active odontogenic processes at the time of cyst removal was established based on prospective clinical and radiological evaluations. The dynamics of mucoperiosteal defect regeneration in the MSC, considering RANKL levels, were assessed 3–6 months post-surgery. Results. In the postoperative period, 8 (32%) out of 25 patients exhibited odontogenic alteration processes in the tissues of the maxilla adjacent to the cysts. The RANKL concentration in these patients was [80.65±34.22] pg/µg of protein, while in the other 17 patients without signs of bone damage, it was [33.10±4.35] pg/µg of protein (p<0.05). The threshold RANKL concentration distinguishing these groups in this study was 51.50 pg/µg of protein. Conclusions. In patients with peri-apical bone changes in the maxilla in the projection area of the cysts (alveolar recess), the RANKL level in their homogenates is higher compared to patients without such pathology. Measuring RANKL levels in the homogenates of cysts removed during endonasal maxillary sinusotomy can serve as an additional indicator for planning postoperative dental treatment in these patients. Keywords: ENT-pathology, endoscopic rhinosurgery, histology, postoperative period, paranasal sinus x-ray, treatment.

Relationship of the accessory maxillary ostium to mucosal thickening and maxillary sinus cysts: a 3D segmentation study

ObjectivesWe aimed to investigate the relationship between the presence of the accessory maxillary ostium (AMO) with mucosal thickening (MT) and maxillary sinus cysts (MSCs). Study DesignThis single-center retrospective study included patients who underwent paranasal sinus CT between November 2022 and February 2023. We excluded patients with natural maxillary ostium (NMO) occlusion. Two radiologists evaluated the presence of AMOs, MT, and MSCs in CT images and measured their dimensions using a 3D volumetric analysis program. ResultsWe included 125 patients (mean age: 36.47± 16.0 years; male/female: 67/58). In total, 65 patients (52%) had single or multiple AMOs. No significant relationship was found between the presence of an AMO and the presence of MT on either side (P ≥ 0.306). There was a statistically significant difference between the presence of an AMO and MSC on the right side (P = 0.002), but not on the left side (P = 0.477). The diameter of the AMO and the distance from the AMO to the maxillary floor were not correlated with mucosal thickness or MSC volume, but the distance from the AMO to the sinus floor had a small positive correlation with total maxillary sinus volume. ConclusionThe presence of an AMO and its increased diameter may not contribute to ipsilateral maxillary sinusitis in patients whose unilateral or bilateral NMOs are not occluded.

Mucosal cyst aspiration in conjunction with maxillary sinus elevation: A clinical cohort study.

Patients with mucosal cysts in the maxillary sinus require special consideration in patients who require implant therapy for the restoration when undergoing implant therapy for the restoration of the posterior maxillary dentition. Treatment strategies for these clinical situations remain controversial in the literature. Thus, this study seeks to describe a safe and effective therapeutic strategy for sinus augmentation in patients with pre-existing maxillary antral cysts. A total of 15 patients and 18 sinuses were consecutively enrolled in this cohort study and underwent maxillary antral cyst treatment by needle aspiration and simultaneous maxillary sinus augmentation (MSA). During surgical procedures, threeimplants (Zimmer Biomet, Indiana, USA) were positioned in 11 sinuses and two implants (Zimmer Biomet, Indiana, USA) were positioned in 5 sinuses. Overall implant success and survival rates were 100% and 97.8%, respectively at 1 year and 5-year follow-ups. Crestal bone resorption averaged 0.3 ± 0.2 mm 5-year post-loading, showing bone stability. Implant survival rate at 5-year follow-up expressed predictability of the technique comparable to historical data when MSA was performed alone. Crestal bone resorption averaged 0.3 ± 0.2 mm 5 years post-loading and shows bone stability utilizing mucosal cyst aspiration with concomitant MSA procedures. Quality of life evaluation at 1-week post-op showed similar results to published historical data. In 81% (13 sinuses), the CBCT examination at 5-year follow-up showed no cyst reformation, in 19% (3 sinuses) cyst reformation was visible, but smaller in size when compared to the pre-op CBCT evaluation, and all the patients were asymptomatic. Maxillary sinus mucosal cyst aspiration with concomitant MSA, may be a viable option to treat maxillary sinus cyst.

Case of spontaneous disappearance of maxillary sinus cyst

Case of spontaneous disappearance of maxillary sinus cyst

Distribution of Misdiagnostic Maxillofacial Nonmalignant Lesions and Conditions in Salah Alden Government

Diagnosis is the corner stone & entry to the treatment of lesions or conditions. Because misdiagnosis leads to incorrect treatment. It is very important to understand the distribution between the most common misdiagnosis nonmalignant lesions& conditions in the maxillofacial region as apart of whole misdiagnosis. Decrease patient complaining. Evaluate the most common misdiagnosis lesions& conditions in maxillofacial region. Decrease load to hospitals& clinics& decrease infections. The data collected by standardized formula for all patients& different patient clinical, radiological examination & methods used to confirm the diagnosis. Total no. are 30 patients, misdiagnosis lesions& conditions 13% (Sinusitis or dental pain), 20% (submandibular Lymphadenitis. or Sialadenitis), 20% (Otalgia). 10%(Psychopath),10%(Trigeminal neuralgia) ,7%(migraine) ,7%( maxillary sinusitis),13%(submandibular saialidinitis). the true diagnosis was 13%,( Oroantral fistula),20%(oro-Cutaneous fistula),20%(Tmj pain),10%(Tmj dislocation),10%(dental pain),7%(dental pain),7%(Maxillary sinus cyst),13%(submandibular Salivary gland stone). The more unorganized medical &or surgical branches interference within region may lead to these misdiagnosis results. Poor educated patients, doctor’s decision with inadequate examination& investigation participate in increase patients complaining

Research Progress of Maxillary Sinus Cyst and Maxillary Posterior Dental Region Implantation

The loss of single or multiple teeth in the maxillary posterior region usually leads to alveolar bone resorption, atrophy, and maxillary sinus cavity gasification, resulting in insufficient vertical bone height of the maxillary posterior alveolar bone, which brings great difficulties to tooth implantation. Maxillary sinus floor lifting is an important method to solve the posterior maxillary bone mass deficiency, which can be divided into internal lifting and external lifting. In order to avoid the occurrence of complications such as maxillary sinus mucosa perforation and facilitate the selection of surgical methods, it is particularly important to accurately understand the anatomical characteristics of maxillary sinus before surgery. Maxillary sinus cyst is the most common benign disease of maxillary sinus. It has always been considered as an absolute contraindication for maxillary sinus floor elevation bone grafting, which seriously restricts the possibility of maxillary sinus bone increment. This article reviews the research progress of maxillary sinus cyst and maxillary posterior dental implantation at home and abroad.

A Massive Dentigerous Cyst in Maxillary Sinus

The dentigerous cysts are odontogenic cysts associated with impacted or unerupted teeth and supernumerary teeth. This is a case report of a large dentigerous cyst encroaching maxillary sinus in a11-year-old female patient where the surgical enucleation was done.

A Rare case of Ectopic tooth associated with Dentigerous cyst in maxillary sinus

Ectopic eruption of teeth may be associated with developmental disturbances, pathologies or may be iatrogenic. Ectopic eruptions of 3rd molar in maxillary sinus is relatively rare. This article reviews a 30 year male who reported to the out-patient department of Oral and Maxillofacial Surgery with complaint of pain and swelling in upper left side of the face since 15-20 days. Orthopantomogram revealed an impacted tooth in left maxillary sinus with cystic lining. Provisional diagnosis of dentigerous cyst in relation to ectopic tooth was made. Surgical removal of the tooth from the maxillary sinus using a standard Caldwell-Luc approach is the treatment of choice along with removal of the associated pathology. Asymptomatic cases should be managed similarly as the tendency to form cyst or tumor is possible.

MORPHOLOGICAL FEATURES OF MAXILLARY SINUS CYSTS BASED ON THE STUDY OF PARTICULAR HISTOCHEMICAL AND IMMUNOHISTOCHEMICAL FACTORS OF INFLAMMATION.

The aim: To study the morphological structure and immunohistochemical markers of inflammatory cells in the maxillary sinus cyst wall. Materials and methods: Biopsy samples of maxillary sinus cysts of 92 operated patients aged 18 to 74 years were studied. We used standard staining with hematoxylin and eosin, PAS reaction, and immunohistochemical analysis with monoclonal antibodies to CD68 (macrophages) and CD3 (T- lymphocytes) to determine morphological features and severity of inflammation and PanCK AE1/AE2 antibodies to identify epithelium state. Results: All patients were divided into 2 groups: 29 patients with retention cysts and 63 with lymphagiotatic cysts (pseudocysts), depending on the unilateral or bilateral epithelial lining of the cyst wall. Retention cysts had the bilateral epithelial lining with a saving its function and structure. The thinned connective tissue layer was filled with separate clusters of lymphocytes and macrophages. Lymphagiotatic cysts were characterized by the unilateral epithelium lining of the wall with signs of degeneration, desquamation, and loss of the mucus-forming function. Dense infiltration of the connective tissue layer by inflammatory cells with pronounced expression is observed. Conclusions: Immunohistochemical analysis with monoclonal antibodies to CD3 and CD68 demonstrated that the inflammatory infiltrate of pseudocysts is represented by T-lymphocytes and different sizes of macrophages. The inflammatory infiltration of the pseudocyst wall was significantly severe compared to retention cysts.

Paranasal Sinus Cysts Encountered Over Twenty Years: Varieties, Management, Recommendations, and Outcome

Background: We recorded all cases presenting with paranasal sinus cysts to draw attention to those with unusual presentations and their management outcome in a retrospective original study. Methods: All patients were subjected to history-taking, ENT examination, endoscopic examination, CT scanning, and managed with endoscopic sinus surgery/or a combined approach. Results: We encountered 54 patients with paranasal sinus cysts. Mucocele/pyocele was the commonest (79.6%), followed by radicular cyst (9.3%), dentigerous cyst (5.55%), and fungocele (5.55%). The frontal sinus was the commonest sinus of cyst origin (55.6%). Maxillary sinus cysts occurred in 16.6% of cases. The sphenoid sinus was the "least" sinus of cyst origin in 7.4% of cases. Conclusion: Ethmoid mucocele occurred mostly by extension from other sinuses, predominantly frontal. With exclusive frontal sinus cysts, it is essential to look for possible underlying pathology or associated complication. Fungocele, a new nomenclature, could complicate those with allergic fungal sinusitis.

A Postoperative Cheek Cyst Originating from the Maxillary Sinus with Orbital Involvement

Purpose: Here we report a case of a postoperative cheek cyst arising from the maxillary sinus with orbital involvement.Case summary: A 56-year-old male presented to our clinic with right periorbital edema and visual impairment. Upon examination, he had a visual field defect and a best corrected visual acuity of 0.6 in the right eye. The patient was diagnosed with a postoperative cheek cyst originating from the maxillary sinus. The cyst developed because of radical maxillary sinus surgery. Computed tomography showed a mass originating from the maxillary sinus. After endoscopic sinus surgery, the best corrected visual acuity of the right eye improved to 1.0 and the periorbital edema was reduced.Conclusion: In patients with orbital involvement of a maxillary sinus cyst, radiographic examination and surgical history of the postoperative cheek cyst can be diagnostic.

Optimal timing of endoscopic sinus surgery for the retention cyst of maxillary sinus.

The optimal timing of functional endoscopic sinus surgery for odontogenic infections precipitated by retention cysts of the maxillary sinus was investigated. Five adults who underwent functional endoscopic sinus surgery were examined. The root apexes of all teeth that had odontogenic infection protruded into the maxillary sinus. All teeth with odontogenic infections precipitated by the retention cysts had percussion pain, indicating they had periodontitis and pulpitis around the root apex. They were vital teeth, indicating they did not have pulp necrosis. The small area of cyst wall attached to the floor of the maxillary sinus and root apex were left intact. The teeth that had odontogenic infections precipitated by retention cysts continued to be vital with no symptoms. Functional endoscopic sinus surgery should be performed before periodontitis and pulpitis of the root apex progress to ascending pulpitis and pulp necrosis. In other words, functional endoscopic sinus surgery should be performed while the affected tooth is still vital.

Infected Dentigerous Cyst of Maxillary Sinus Mimicking Intraoral Abscess in a Pediatric Patient: Management of Misdiagnosis and Inaccurate Treatment

The article presents the case of a 12-year-old male patient who was suffering from exacerbated (infected) dentigerous cyst of maxillary sinus, associated with impacted canine whose symptoms were deceptively similar to intraoral abscess. The first-aid treatment performed by general dental practitioner consisted of intraoral incision and resulted in oroantral fistula formation. Eventually, the patient's ailments were not resolved, and we had to deal with serious local complications and difficulties. The treatment was performed under general anesthesia in one-day surgery system and included enucleation of the lesion, excision, and closure of oroantral fistula. Dislocated canine was not removed, and its subsequent eruption was observed.

КИСТЫ ВЕРХНЕЧЕЛЮСТНЫХ ПАЗУХ У ДЕТЕЙ

Cysts of maxillary sinuses in both children and adults haven’t specific clinical manifestations and are often findings on CT or MRI and have an odontogenic or non­odontogenic origin. Systematized data of the prevalence and flow characteristics of this pathology in children are insufficient. Objectives: clinical and epidemiological analysis of cystic maxillary sinusitis in children. Material and methods: data of 42 patients of the children’s ENT­department who were operated for non­odontogenic cysts of maxillary sinuses. Results. Age of group patients in which the studied pathology was diagnosed most frequently was 10–17 years old. Correlation of the cysts of maxillary sinus with pathology of the nasal cavity and nasopharynx were analyzed: septal deviation (68 %), rhinitis (42 %), adenoids (10 %), anthroanal polyp (25 %) was noted. Pathomorphological examination of the material obtained at endoscopic removal of cysts presence of inflammatory in 78 % of biopsy. Conclusion. In most cases a patient with a cyst of maxillary sinus is subject to dynamic observation by an otorhinolaryngologist and endoscopic examination of the nasal cavity is an essential element for timely detection of pathology of the ostiomeatal complex or choanal polyp accompanying the cyst development.

Тактика ведения пациентов с кистами верхнечелюстных пазух

Cystic lesions of the maxillary sinuses include cysts, polyps and neoplasms. Maxillary sinus cysts are benign lesions that are commonly an incidental finding during X–ray, since any symptoms do not accompany their presence. An urgent problem is the development of differential diagnostics, the determination of indications for surgical treatment and the optimal treatment tactics for patients with cystic lesions of the maxillary sinuses. The authors describe their experience in patient management with maxillary sinus cysts. 175 patients (mean age — 44.93 years) with lesions in the maxillary sinus were examined and surgically operated. All patients underwent a comprehensive clinical examination aimed at a differential diagnosis of maxillary sinus pathology: cysts, polyps and neoplasms. All patients underwent endoscopic endonasal surgery: in 135 cases it was conducted via the inferior nasal meatus, in 40 patients — via the middle nasal meatus due to the large size of the cyst. Histology confirmed the established diagnosis during the clinical and instrumental examination. The postoperative period proceeded with no abnormalities. After 6 months, the patients underwent a control computed tomography of paranasal sinuses. In all cases, there was a complete cyst removal and restoration of sinus pneumatization. Thus, the differential diagnosis concerning cystic lesions of the maxillary sinus should be based on clinical manifestations and the results of X-ray techniques and follow-up of patients with scanty symptoms and signs. The optimal treatment method of maxillary sinus cysts is the endoscopic endonasal approach, followed by morphological examination. KEYWORDS: benign lesion, maxillary sinus cyst, cystic lesion, differential diagnosis, endoscopy, endoscopic endonasal approach. FOR CITATION: Karpishchenko S.A., Zernitsky A.Y., Vereshchagina O.E. et al. Patient management with maxillary sinus cysts. Russian Medical Inquiry. 2022;6(7):411–415 (in Russ.). DOI: 10.32364/2587-6821-2022-6-7-411-415.

Prevalence of and factors associated with maxillary sinus cyst in a Chinese population.

This study used cone-beam computed tomography (CBCT) to assess the prevalence of and factors associated with maxillary sinus cysts (MSCs) in a Chinese population. A total of 2,571 CBCT scans of 5,000 sinuses were analyzed. MSCs were diagnosed on the basis of imaging features within the maxillary sinus. Sex, age, dental condition, and anatomic condition were assessed. Associations with these factors were evaluated with logistic regression and a generalized estimating equations model. The prevalence of MSCs was 15.46% at the sinus level and 23.44% at the patient level. The prevalence of MSCs was higher for men (OR = 1.864, P < 0.001) and for patients with apical lesions (OR = 1.76, P < 0.001), severe bone loss (OR = 1.363, P < 0.05), tooth roots in contact with the sinus floor (OR = 1.68, P < 0.001), and pits or septa on the floor of the maxillary sinus (OR = 1.539, P < 0.001). This large sample had a high prevalence of MSCs. MSC prevalence was associated with multiple factors, including sex, dental condition, and anatomic condition. Maintenance of healthy dental and periodontal status might help prevent MSCs.

An Undiagnosed Case of Mucous Retention Cyst of Maxillary Sinus- A Case Report of a 10-year-old Lesion

Mucous Retention Cyst of paranasal sinuses is rare. In comparison with the other paranasal sinuses, its incidence in the maxillary antrum is very less. Anatomically the maxillary sinus is in close vicinity to the maxillary alveolus and dentition of the oral cavity. Pathologies involving these anatomical regions can manifest in both the sites or either of the site leading to diagnostic dilemmas. Maxillary sinus pathologies most often produce oral symptoms and hence may be misdiagnosed initially thereby causing delayed treatment. Hence, careful evaluation and management are highly essential. This article reports a case of mucous retention cyst of maxillary sinus mimicking maxillary tooth pathology leading to delayed management. The described case is a 38-year-old male patient having well-defined firm swelling on the middle 1/3rd of the face, with obliteration of buccal vestibule in the region of missing left maxillary first molar (26) mimicking residual cyst. The left maxillary first molar tooth had been extracted 10 years back due to its misdiagnosis as tooth pathology. Orthopantomograph showed loss of floor of the maxillary sinus with well-defined dome-shaped radiolucency with sclerotic borders extending into the sinus. Histopathology confirmed the diagnosis of maxillary sinus pathology

Cytokine profile of chronic rhinosinusitis without polyps

Chronic rhinosinusitis (CRS) is the most common immunological ENT disease, which has several phenotypes. The heterogeneity of CRS is due to the peculiarities of their pathogenetic mechanisms - the system of cytokines plays the crucial significance. They are biologically active substances and present regulatory peptides that demonstrate an immunomodulatory and regulatory effects not only in the local level but the system level as well. To determine specific features of the cytokine profile in blood serum among patients with CRS without polyps (CRSwP). Serum cytokines (IL-1α, IL-1RA, IL-1β, IL-2, IL-3, IL-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL-10, IL-12p40, IL-12p70, IL-13, IL-15, IL-17, IFN-α2, IFN-γ, GM-CSF) were defined in 75 patients: 32 patients with CRSwP were operated (main group) - 17 with cyst of maxillary sinus, 15 with edema of the maxillary sinuses. The control group - 43 patients were under surgery for a deviated nasal septum (septoplasty). The groups were comparable to gender and age. The cytokines detection rate was different in all groups. IL-4 (detection rate 93.3-95.3%) and IFN-γ (79.1-86.7%) were measured nearly the all groups. IL-8 (73.3-76.5%) and IL-17 (76.5-80.0%) were often measured in the group with CRSwP; in contrast to the control group - these indicators were lower: 60.5% and 65.5%, respectively. IL-1α (82.4%) and IFN-α2 (76.5%) were often detected in CRS with cystic formations. IL-1β, IL-5, IL-7, IL-9, IL-15 were measured in all groups in less than 30% of patients; IL-2 and IL-6 - in the group of CRS with cystic formation; IL-10, IL-12p40, IL-13 in the group with edema of maxillary sinuses. In a quantitative comparison of the concentration of cytokines. Significant differences in concentration of cytokines between the groups were not obtained (p>0.05) in terms of quantity. CRSwP with cystic formation is characterized by the development of T2 type immune response and a higher inflammation-related tissue damage.

Удаление радикулярной кисты верхней челюсти с одноэтапной хирургической коррекцией структур полости носа

A radicular cyst is the most common odontogenic cyst. It gets its development from the periapical focus of infection that arose against the background of a complicated course of dental caries. In clinical practice, odontogenic cysts must be differentiated from other neoplasms of the maxillofacial region. One of the radiological signs of an odontogenic cyst is the presence of a bone shell with radiolucent contents. As a rule, the clinical manifestations of a radicular cyst are scanty, and the diagnosis is made on the basis of an X-ray examination, being an accidental finding. The article presents a clinical case of a radicular cyst of the upper jaw that grows into the maxillary sinus and pushes the lower wall of the sinus without violating its integrity. The cyst turned out to be an accidental finding during examination by an otorhinolaryngologist. The patient complained about the discharge of their nasal cavity, difficult nasal breathing. After performing computed tomography and joint examination of the patient by an otorhinolaryngologist and a maxillofacial surgeon, the diagnosis was formulated: curvature of the nasal septum, vasomotor rhinitis, radicular cyst of the right maxillary sinus from the 26th tooth. After the diagnosis and comprehensive assessment of the oral cavity and paranasal sinuses, surgical treatment was performed jointly by an otorhinolaryngologist and a maxillofacial surgeon with a satisfactory result. This case is of particular clinical interest in the practice of an otorhinolaryngologist and a maxillofacial surgeon preparing for dental implantological treatment of the oral cavity.