Nasopalatine Duct Cyst Research Articles

MR imaging of epithelial cysts of the oral and maxillofacial region

The aim of the present study was to review the magnetic resonance (MR) appearance of primary epithelial cysts in order to distinguish the cysts from other possible lesions. MR images were obtained in 27 cases of epithelial cysts, including 7 odontogenic keratocysts, 3 dentigerous cysts, 1 glandular odontogenic cyst, 10 radicular cysts, 4 nasopalatine duct cysts, and 2 nasolabial cysts. In addition, contrast enhanced MR imagings were performed in 12 cases, including 3 odontogenic keratocysts, 1 dentigerous cyst, 1 glandular odontogenic cyst, and 7 radicular cysts. We obtained the following results on the basis of the above MR and contrast enhanced MR findings. (a) Odontogenic keratocysts had a predilection for intermediate–high signal intensity (SI) on T1-weighted images (WI) and heterogeneous low–high SI on T2WI. (b) Dentigerous cysts, glandular odontogenic cyst, radicular cysts and nasolabial cysts showed the same predilection with the SI, which were homogeneous intermediate SI on T1WI and homogeneous high SI on T2WI. (c) The MR images of the nasopalatine duct cysts, which showed homogeneous high SI on T1WI, were specific. (d) The Gd-T1WI would be useful in decisively differentiating odontogenic cysts, which showed rim-enhancement, from tumors consisting of solid components. In conclusion, we were able to obtain more information from the MR and contrast enhanced MR images than from conventional radiograph findings.

MR imaging of nasopalatine duct cysts

We describe the magnetic resonance (MR) features of two cases of nasopalatine duct cyst (NPDC), including the first presentation of T1-weighted images (WI). The signal intensity of the cases of NPDC showed homogeneous high signal intensity on both on T1 and T2WI, although most cysts of maxillofacial regions demonstrate low to intermediate signal intensity on T1WI. NPDC may commonly be of high signal intensity on T1WI, which is consistent with keratin and viscous fluids.

Nasopalatine duct cyst: a case report.

A case of a nasopalatine duct cyst is reported in an 8-year-old. The clinical presentation was of intermittent palatal swelling and the diagnosis was confirmed with radiological and histological examination. This type of cyst is rare in children and should not be excluded from a differential diagnosis in younger age groups.

自家海綿骨で再建を行った鼻口蓋管嚢胞例

Nasopalatine duct cyst is a nonodontogenic cyst that arises from the remains of the nasopalatine duct. It is comparatively rare among all cysts of the maxilla.A 29-year-old male visited our clinic because of an increasing anterior midline palatal mass. MR imaging showed a large cystic lesion, which was 32 mm in diameter, arising within the nasopalatine duct. After removal of the cyst, a large dead space remained. It was reconstructed with autogenous cancellous bone of the iliac crest. At the time of 6 months after the surgery, 3 dimensional CT demonstrated good contour of the palatal bone. Autogenous cancellous bone is very useful and reliable material for the reconstruction of palatal bone defects.

Retrospective analysis of 31 cases of nasopalatine duct cyst.

To perform a retrospective analysis of patients with nasopalatine duct cysts (NPDC) in Brazil and compare with previous analyses. The files of the Laboratory of Oral Pathology (Minas Gerais Federal University) from 1966 to 1997 were reviewed. Demographic, clinical and histologic data of patients with nasopalatine duct cysts were collected. The mean age of patients with nasopalatine duct cysts at the time of diagnosis was 37.4 years and with a predilection for males. The majority of cases were asymptomatic. Histologically, non-keratinized stratified squamous epithelium alone or in combination with other epithelia was observed in 93% of the cases. Recurrence was not recorded. The demographic, histopathological, radiographic, and clinical data of the NPDC in our series are similar to previous studies in other populations.

鼻口蓋管嚢胞を伴った多発性内分泌腺腫症ＩＩｂ型の１例

Multiple endocrine neoplasia (MEN) type II b is a syndrome associated with medullary thyroid carcinoma, phenochromocytoma, and multiple mucosal neuromas. We encountered a rare case of MEN type II b with a palatal cyst and an impacted supernumerary tooth. A 46-year-old man presented to Okazaki municipal hospital because of pain of the palate. He had bumpy lips, multiple diffuse tumors of the oral mucosa, and an open bite. After operation for the palatal cyst, the blood pressure fluctuated widely, ranging from 110/70 to 300/160mmHg. Further examination revealed that he had phenochromocytoma and medullary thyroid carcinoma with lymph node metastases. The palatal cyst was a nasopalatine duct cyst with an impacted supernumerary tooth. Multiple mucosal tumors were diagnosed as neuromas on examination of biopsy specimens.

Odontogenic keratocysts of the midline maxillary region.

This article compares the demographic features of the anterior midline maxillary odontogenic keratocyst with those in other regions. The data on 18 cases of anterior midline maxillary odontogenic keratocyst were reviewed. Thirteen of the cases were in men (72.2%), and 16 of the patients (88.9%) were past the age of 60 years. The mean age of the patients was 69.9 years, which is much higher than for odontogenic keratocysts in other locations. The most common clinical diagnoses were periapical cyst and nasopalatine duct cyst. It is important to include odontogenic keratocyst in the differential diagnosis of anterior midline maxillary radiolucencies, especially when they occur in older individuals.

Odontogenic keratocysts of the midline maxillary region

Abstract Purpose: This article compares the demographic features of the anterior midline maxillary odontogenic keratocyst with those in other regions. Materials and Methods: The data on 18 cases of anterior midline maxillary odontogenic keratocyst were reviewed. Results: Thirteen of the cases were in men (72.2%), and 16 of the patients (88.9%) were past the age of 60 years. The mean age of the patients was 69.9 years, which is much higher than for odontogenic keratocysts in other locations. The most common clinical diagnoses were periapical cyst and nasopalatine duct cyst. Conclusion: It is important to include odontogenic keratocyst in the differential diagnosis of anterior midline maxillary radiolucencies, especially when they occur in older individuals.

Squamous cell carcinoma in the maxilla probably originating from a nasopalatine duct cyst: Report of case

Squamous cell carcinoma in the maxilla probably originating from a nasopalatine duct cyst: Report of case

Misdiagnosis and mismanagement of a nasoplatine duct cyst and its corrective therapy: A case report

A case is presented in which a nasopalatine duct cyst was misdiagnosed. Its subsequent mismanagement was further compounded with improper endodontic therapy. It was finally managed by corrective endodontic and surgical therapy.

Metrical differential diagnosis based on location. Differential diagnosis among various cysts.

An attempt was made to quantify the location of oral lesions. Panoramic radiographs of non-odontogenic cysts (13 globulomaxillary cysts, 8 median maxillary cysts, 8 nasopalatine cysts, 5 nasoalveolar cysts and 11 simple bone cysts) and odontogenic cysts (37 radicular cysts, 13 radicular granulomas, 68 dentigerous cysts and 40 odontogenic keratocysts) were examined. Metrical data (integers) were obtained from a conversion table and the abscissa values (to the first decimal place) were obtained from the centroid of the cysts. Differential diagnosis among these lesions revealed the following: 1. In the maxilla, it was possible to differentiate median maxillary cysts and nasopalatine cysts from globulomaxillary cysts, nasoalveolar cysts, radicular cysts, radicular granulomas, dentigerous cysts and odontogenic keratocysts. 2. In the mandible, it was difficult to differentiate simple bone cysts, radicular cysts, radicular granulomas, dentigerous cysts and odontogenic keratocysts from one another. The present findings revealed that data on lesion location can be changed into metrical data for differential diagnosis of cysts.

Relative incidence of odontogenic tumors and oral and jaw cysts in a Canadian population

The diagnoses of 40,000 consecutively accessioned oral biopsies from the Oral Pathology Diagnostic Service, University of Western Ontario, London, Canada, were reviewed. All odontogenic neoplasms, neoplasm-like lesions (tumors), and true cysts of the oral tissues and jaws were listed. Clinical data were reviewed, and microscopic diagnoses were confirmed for cases in which diagnoses were ambiguous. Records of all cases were examined to identify distant referrals that were not representative of the study population. Of a total of 445 (1.11%) odontogenic tumors, 392 (0.98%) were lesions from patients in the usual local drawing area of the biopsy service; 53 were referred from distant centers. From the local population, odontomas were by far the most common tumor (51.53%) followed by ameloblastomas (13.52%) and peripheral odontogenic fibromas (8.93%). Locally, radicular (periapical) cysts were the most common odontogenic cyst (65.15%) followed by the dentigerous cyst (24.08%) and the odontogenic keratocyst (4.88%). The most common nonodontogenic cyst was the nasopalatine duct cyst that accounted for 73.43% of this subset of cysts. Surprisingly few studies of this type are available, especially for odontogenic tumors. These data are important to assess geographic differences in the incidence of lesions and to allow clinicians to make realistic judgments in counseling patients before biopsy about the probability of diagnosis and risks associated with nonspecific clinical or radiographic lesions.

A retrospective analysis of 367 cystic lesions of the jaw—the Ulm experience

Out of 846 cyst-like lesions of the jaws, 367 cases were retrieved from the files of the Department of Oral and Maxillofacial Surgery at the University of Ulm and classified according to the new World Health Organization's classification for odontogenic tumours and cysts. Radicular and residual cysts comprised 56.9%, dentigerous cysts 21.3%, odontogenic keratocysts 10.6%, unicystic ameloblastomas 4.1%, nasopalatine duct cysts 2.7%, glandular odontogenic cysts 1.6% and paradental cysts, traumatic bone cysts, calcifying odontogenic cyst and lateral periodontal cyst each less than 1% of the sample. Nearly one third of the specimens were obtained from military patients; despite an expected bias towards young males, unicystic ameloblastomas presented one and a half decades later than is generally reported.

Nasopalatine duct cyst: An analysis of 334 cases

The nasopalatine duct cyst (NPDC) is the most common cyst of nonodontogenic origin in the maxilla. However, the information reported about this lesion consists primarily of small surveys and isolated case reports. The purpose of this retrospective investigation was to gather demographic, clinical, and histologic data on a large series of NPDCs, and to compare the findings with those of previous studies. In this study, the overall mean age at diagnosis was 42.5 years, and there was a slight male predilection. The mean radiographic diameter was 17.1 mm, but 75% of the lesions were 20 mm or less in diameter. Symptoms were present in at least 70% of the cases. Only 28% of the specimens contained respiratory epithelium. There was no correlation between radiographic size, patient's age, presenting symptoms, or type of epithelium. Recurrence was noted in only 2% of the cases.

Well-Defined Radiolucent Lesion in the Maxillary Anterior Region

A case of nasopalatine duct cyst is described. Such cysts often remain asymptomatic for lengthy periods and may be discovered during routine radiography. The quiescent nature of this cyst underscores the importance of thorough clinical and radiographic examination before the fabrication of a prosthesis, as such cysts may give rise to acute infection, enlargement, and penetration through the overlying mucosa if not removed before denture insertion.

顎骨嚢胞におけるＴ‐ｚｏｎｅ組織球の分布に関する研究

In order to investigate the potential role of the cell-mediated immune system in jaw cysts, the presence and distribution of T-zone histiocytes (Langerhans cells and indeterminate cells) were studied immunohistochemically using antisera to S-100 protein in the walls of six different groups of jaw cysts in relation to the degree of inflammatory cell infiltration (macrophages, MT-1 positive lymphocytes, MB-1 positive lymphocytes, plasma cells and neutrophils) and the thickness and type of covering epithelium. Materials consisted of 42 radicular cysts, 19 odontogenic keratocysts, 9 dentigerous cysts, 8 postoperative maxillary cysts, 7 nasopalatine duct cysts and 7 cysts of unknown diagnosis. Twenty samples of oral mucosa served as control.In contrast to 95% in the control oral mucosa, intraepithelial T-zone histiocytes were found in only 37% of 75 cysts having epithelial lining. The value in the supporting connective tissue was 74% and T-zone histiocytes were found more often in cysts with inflammatory cell infiltration. The mean numbers of T-zone histiocytes in a given field of the connective tissue for radicular cysts, odontogenic keratocysts, dentigerous cysts, postoperative maxillary cysts, nasopalatine duct cysts, cysts of unknown diagnosis and oral mucosa were 1.2, 1.2, 4.9, 0.2, 1.3, 2.6 and 2.5, respectively. A tendency to decreased T-zone histiocytes was observed in radicular cysts with little to very mild or severe inflammatory cell infiltration, but like in oral mucosa, the number in the odontogenic keratocyst-dentigerous cyst group was related to that of inflammatory cells, whereas there was no such correlation in the postoperative maxillary cyst-nasopalatine duct cyst group. A significant correlation was also observed between the number of T-zone histiocytes and the thickness of the covering epithelium in all cysts but those of unknown diagnosis. In addition to the thickness of covering epithelium, MT-1 and MB-1 positive lymphocytes were the factors related to the number of T-zone histiocytes in radicular cysts and odontogenic keratocyst-dentigerous cyst group in the multiple regression analysis.In conclusion, T-zone histiocytes were found to be contributing in the induction of immune response in the presence of adequate inflammation except when it is too mild or too severe to cause extensive damage of cyst wall tissues. However, further study is needed to clarify their contribution in cysts with epithelial lining of respiratory origin.

Pigmented nasopalatine duct cyst. Report of 2 cases

Dendritic cells containing melanin pigment have been demonstrated in the epithelial lining of 2 pigmented nasopalatine duct cysts. The significance of this observation is discussed.

Cytokeratin expression of the odontogenic epithelia in dental follicles and developmental cysts

The patterns of cytokeratin expression in the epithelium of 5 dental follicles, 7 dentigerous cysts, 5 odontogenic keratocysts, 3 nasopalatine cysts and an epidermoid cyst have been studies using a panel of monoclonal antibodies. The epithelium of dental follicles and of developmental odontogenic cysts strongly expressed keratins 5 and 19 and showed weaker expression of keratins typical of stratified non-cornified and of simple epithelia. Staining with mAbs against the latter keratins varied with the degree of epithelial differentiation. Nasopalatine cysts strongly expressed simple epithelial keratins and the epidermoid cyst strongly expressed a marker of cornification. Odontogenic cysts thus appear to differ in their pattern of keratin expression from other oral developmental cysts and all derivatives of odontogenic epithelia appear to share similar basic patterns of cytokeratin expression.

巨大な鼻口蓋嚢胞症例における手術法の検討

A 23-year-old male had a nasopalatine cyst, which caused 6×6×4cm defect in the maxillary bone and reached the oral vestibule and the floor of the nasal cavity. The cyst was completely removed, ` and 2-directional drainage routes for exudative fluid were made by mucosal resection in the floor of the nasal cavity and by opening of the left maxillary sinus. Postoperatively, the bone defect space filled up gradually with granulation tissue.A review of the operative methods of treating nasopalatine cysts and our experience in this case lead us to stress the importance of multiple directional drainage, especially if there is a large bone defect space, after removal of the cyst. For that purpose transmaxillary-sinus drainage is useful.

The radiologic features of the nasopalatine duct cyst. An analysis of 46 cases.

The radiologic features of 46 nasopalatine duct cysts were characterized by two oral radiologists. Most cysts were bilateral, well demarcated, well corticated and with an entirely radiolucent lumen. Amorphous intraluminal calcifications were visible in 13%. Twenty-five cysts had caused bony expansion and 16 of those were also associated with partial erosion of the overlying cortex. Teeth, when present, were frequently displaced, with their roots directed distally: root resorption was present in 14% of cases.