Surgical ciliated cyst after maxillary orthognathic surgery: report of a case

Transoral Marsupialization of an Isolated Surgical Ciliated Cyst of the Infratemporal Fossa

Surgical ciliated cysts occur primarily in the maxilla after radical maxillary sinus surgery. We report the first case of a surgical ciliated cyst that developed in the infratemporal fossa 25 years after the patient sustained severe facial trauma. The patient complained of mandibular pain and limited mouth opening. The patient's condition was completely resolved 5 months after marsupialization via Le Fort I osteotomy. Surgical morbidities can be minimized by proper diagnosis and less invasive surgery.

Occurrence of a postoperative maxillary mucocele 20 years after orbital wall reconstruction

Mucoceles of the paranasal sinus are epithelial-lined cystic structures filled with mucus and have multiple etiologies, including recurrent inflammation, trauma, or intrinsic disease. Particularly, a postoperative maxillary mucocele (POMM) is a delayed complication of radical surgery of the maxillary sinus, and most cases occur after Caldwell-Luc operations. Patients mainly complain of facial swelling, toothache, and tenderness. POMM has rarely been reported from other causes; however, there have been no reports on the occurrence of POMM following orbital wall reconstruction. Herein, we report a case of a patient with a POMM that developed 20 years after the aforementioned surgery. The patient complained of facial pain with visual disturbance, and underwent marsupialization using a combination of sublabial and endoscopic approaches, and the symptoms improved without recurrence.

Large Grafting Void Resembling a Surgical Ciliated Cyst following Maxillary Sinus Augmentation. Four Case Reports with Histological Observation

The cause and pathogenicity of grafting voids following lateral maxillary sinus augmentation (MSA) have not yet been elucidated. The first purpose of this case series is to introduce an unusually large grafting void that radiologically resembles a surgical ciliated cyst (SCC) at the sinus augmented site; the second is to observe the histological findings of these grafting voids. In four patients, MSA was performed using the lateral window technique. An unusually large grafting void appeared on cone-beam-computed tomography (CBCT) taken one week after surgery and except for one patient, there were no clinical symptoms. On CBCT taken six months after surgery, the grafting voids were slightly smaller in size but showed radiographic findings similar to those of SCC. During uncovering, grafting voids were removed through the lateral window site. Histologically, the grafting void was empty or filled with dense connective tissue, and no ciliated columnar epithelium or inflammatory cells were observed. Within the limitations of this case series, the large grafting voids generated after MSA was not converted to SCCs. Rather, they remained scar tissue, which could infringe the sinus bone graft and affect the apical bone support of the implant.

Surgical ciliated cyst after a mandibular surgery: a particular case report and review of the literature

Background

Surgical ciliated cyst is a rare clinicopathological lesion that appears in patients who undergo maxillofacial surgery. In this report we present a particular mandibular case and we discuss the etiopathogenesis and clinicopathological features of this pathology after reviewing the current literature, as well as the origin of its respiratory epithelial profile.

Case presentation

The patient is a 67-year-old male with an irregular radiolucency in a previously tooth extracted area of the mandible. The histopathological study revealed a cystic lesion with a connective wall with chronic inflammation, partially lined by a ciliated pseudostratified epithelium. PAS and CK19 stains showed the respiratory characteristics of this epithelium and confirmed the final diagnosis of mandibular surgical ciliated cyst.

Conclusions

Surgical ciliated cyst is an uncommon entity associated with maxillofacial surgical procedures with bone and nasal cartilage grafts. In our case, treatment with growth factors present in platelet-rich plasma could explain the respiratory changes observed in the cystic epithelial lining.”

Maxillary surgical ciliated cysts following advancement Le Fort I osteotomy with concomitant autogenous bone grafting: a simple coincidence or a cause-effect relationship?

Surgical ciliated cysts (SCCs) are rare benign lesions that have been described after radical maxillary sinus surgery such as a Caldwell-Luc procedure for chronic sinusitis. They usually occur several years following surgery, and they typically present as an evolving swelling in the maxillary sulcus and cheek area. The pathogenetic mechanism is related to the entrapment of respiratory epithelium from the paranasal sinuses and/or the nose within the wound created by the surgical procedures. Radiologically, SCCs manifest as a well-demarcated, unilocular or multilocular radiolucency and histologically are lined by respiratory epithelium. Enucleation remains the treatment of choice. Since the 1990s, cases of SCCs have also been described following orthognathic surgery and developing not only within the maxilla but also surprisingly within the mandible. We report here three unique cases of patients with postoperative maxillary cysts following Le Fort I advancement osteotomy with concomitant inter-positional gap autogenous bone grafting.

Surgical Ciliated Cysts in Orthognathic Surgery

ABSTRACT

Surgical ciliated cysts (SCC) are rare entities that were first described in the Japanese literature after treatment for chronic maxillary sinusitis. Classically associated with surgery to the maxillary sinus, they have also been reported in association with orthognathic surgery, bone grafting, and trauma. These lesions can develop from a few months up to several years after the surgical procedure. The authors report 2 new cases of SCC after a LeFort I osteotomy for class III dentofacial deformity correction. One of them presented with bilateral lesions and suffered from a recurrence after 5 years, 2 rare events associated with SCC.A review of the literature of the past 5 years was undertaken, in order to ascertain the reported time of follow-up and recurrence. A PubMed search retrieved a total of 15 articles with 17 cases reported. Nine cases were associated with orthognathic surgery, 4 with Caldwell-Luc procedures, 2 with sinus lift and 2 with trauma. The mean follow-up after removal of the SCC was of 8.6 months. Four cases did not specify the follow up time; 1 case was lost to follow-up. No relapses were reported.Like what happens with the primary lesion, a recurrence can take place several years after removal. It is the authors' opinion that adequate long-term follow-up must be granted for a timely diagnosis and treatment of relapsed SCC.

Successful Management of Dental Implants in Postoperative Maxillary Cyst: A Case Report With a 13-Year Follow-Up

The report is presenting a case of implant placement in the postoperative maxillary cyst (POMC) with a follow-up of 13 years. The POMC is a complication associated with various surgical interventions involving maxillary sinus diseases such as Caldwell-Luc operation, orthognathic surgery, and sinus grafting procedures. The lesion of POMC is believed to develop as a result of the changes of ciliated cells or the blockage of ostia inside the maxillary sinus. Two dental implants were placed near the lesion that was later confirmed to be POMC. Of the 2 dental implants placed, one was explanted and the other was successfully managed with surface debridement followed by guided bone regeneration. The removed specimen inclusive of the implant and surrounding tissue was evaluated with clinical photographs, radiographs, and histology and the findings are described in the paper.

Surgical ciliated cyst after maxillary orthognathic surgery: a literature review and case report

PURPOSE

Surgical ciliated cyst of the maxilla is a rare complication following surgical procedures or trauma involving the maxillary sinus. The surgical ciliated cyst of the maxilla is a rare lesion and appears as a delayed complication after surgery in the maxillary sinus, midface osteotomies, traumatic tooth extraction and maxillary fractures.

CASE REPORT AND LITERATURE REVIEW

We report a case that occurred 5 years after a maxillary sinus surgery in a Caucasian Female. A well-defined unilocular radiolucency in the right anterior maxilla was noted in cone beam image associated to osteosynthesis material. The lesion was completely excised, and upon histological examination, findings were consistent with Ciliated cyst. The PubMed database was searched for PMC within the last 15 years.

RESULTS

Together with the current case, we found 18 reports including 21 patients describing PMC. It wasdiagnosed at a mean time of 22 years after causal surgery at a mean age of 47 years. The main radiologicalsign was a unilocular radiolucency.

DISCUSSION

This lesion may present histologically different epithelial linings, but respiratory epithelium was the most frequent. The most important clinical and pathological features of these conditions are also discussed.

CONCLUSION

Although surgical ciliated cysts have only rarely been reported after orthognathic surgery, anincreased awareness of this possibility is necessary to avoid delays in diagnosis.

Surgical Ciliated Cyst Following Maxillary Sinus Floor Augmentation: A Case Report

Maxillary sinus floor augmentation is considered to play a critical role in dental implant treatment. Although many complications, such as maxillary sinusitis and infection, are well known, few reports are available on the risk of surgical ciliated cyst following the procedure. Here, we report a case of surgical ciliated cyst following maxillary sinus floor augmentation. A 55-year-old Japanese woman was referred to our hospital because of alveolar bone atrophy in the bilateral maxilla. We performed bilateral maxillary sinus floor augmentation by the lateral window technique without covering the window. The Schneiderian membrane did not perforate during the operation. She returned to our hospital after 9 years due to swelling of the left buccal region. Computerized tomography revealed a well-defined radiolucent area with radiodense border intraosseously localized in the left maxilla. We performed enucleation of the cyst with the patient under general anesthesia. Histological examination of the specimen showed a surgical ciliated cyst. In conclusion, the course of this patient has 2 important implications. First, the sinus membrane entrapped in the grafted bone without visible perforation and or tearing can develop into a surgical ciliated cyst. Second, there is a possibility that covering the lateral window tightly might prevent the development of a surgical ciliated cyst.

Transnasal endoscopic removal of bilateral postoperative maxillary cysts after aesthetic orthognathic ssurgery: Differences from that of Caldwell-Luc operations

Postoperative maxillary cysts (PMCs) after orthognathic surgery are a rare disease condition. In this study, we reported first case of bilateral PMCs after cosmetic orthognathic surgery which was treated via the intranasal endoscopic approach. In addition, we compared the characteristics of PMCs after aesthetic orthognathic surgery with those of PMCs after Caldwell-Luc operation. We expect that this case will be helpful to surgeons who encounter similar cases.

Bilateral Postoperative Cyst after Maxillary Sinus Surgery: Report of a Case and Systematic Review of the Literature

Purpose. We present a case of a bilateral postoperative maxillary cyst (PMC) and discuss this with a systemic review. Case Report and Literature Review. A 68-year-old female with pain and swelling on the right side of the face. MRI and CT showed a cystic tumors of the right and left maxillary sinus. Radical maxillary surgery via a Caldwell-Luc procedure had been performed 55 years ago and bilateral PMC was diagnosed. The PubMed database was searched for PMC within the last 30 years. Results. Together with the current case, we found 23 reports including 284 patients describing PMC. It was diagnosed at a mean time of 22 years after causal surgery at a mean age of 47 years. Initial symptoms were mostly pain with or without swelling. The main radiological sign was a unilocular radiolucency with a slight preference for the left side. Discussion. PMC is a long-term complication that can occur after maxillary sinus surgery and a second surgical approach is required in order to stop cystic expansion. Therefore, patients' informed consent on this complication as well as a prolonged follow-up is recommended. Simple paranasal ultrasound or paranasal sinus plain radiography may lead to an earlier detection reducing interventional morbidity.

The effect of radiographic imaging modalities and the observer's experience on postoperative maxillary cyst assessment

Purpose

The purpose of this study was to compare the accuracy of postoperative maxillary cyst (POMC) diagnosis by panoramic radiographs versus computed tomography (CT) and by oral and maxillofacial radiologists versus non-specialists.

Materials and Methods

Sixty-five maxillary sinuses with POMCs and 63 without any lesion were assessed using panoramic radiographs and CT images by five oral and maxillofacial radiologists and five non-specialists on a five-point scale. The areas under receiver operating characteristic (ROC) curves were analyzed to determine the differences in diagnostic accuracy between the two imaging modalities and between the two groups of observers. The intra-observer agreement was determined, too.

Results

The diagnostic accuracy of CT images was higher than that of panoramic radiographs in both groups of observers (p<0.05). The diagnostic accuracy of oral and maxillofacial radiologists for each method was higher than that of non-specialists (p<0.05).

Conclusion

The use of CT improves the diagnosis of POMC, and radiological training and experience leads to more accurate evaluation.

Bilateral postoperative maxillary cysts after orthognathic surgery: A case report

Postoperative maxillary cysts are locally aggressive lesions, usually developing as delayed complications many years after radical antral surgery. This report describes a case of bilateral postoperative maxillary cysts following orthognathic surgery performed approximately 21 years previously. The patient complained of stinging pain on her right cheek. Radiographic examination revealed low-attenuation lesions on both maxillary sinuses with discontinuously corticated margins without distinct expansion or bone destruction. The cysts were enucleated with the removal of metal plates and screws for pain relief. Histopathological examination confirmed the diagnosis of postoperative maxillary cysts lined by ciliated, pseudostratified columnar cells. The patient has remained asymptomatic thus far, and there was no evidence of local recurrence at 21 months of postoperative follow-up.

Postoperative maxillary cysts: magnetic resonance imaging compared with computerized tomography

OBJECTIVES

The aim was to investigate magnetic resonance (MR) and computerized tomography (CT) images and compare MR and CT image features of postoperative maxillary cysts (POMC).

STUDY DESIGN

We retrospectively evaluated MR and CT images of 7 POMC patients. Number of the cysts, border, bone expansion, CT value, signal intensity, and contrast enhancement were observed.

RESULTS

On CT images, 15 cysts were detected. Fourteen cysts showed smooth border. Bone expansion was found in 10 cysts. Mean CT value of each cyst ranged from 23 to 50 Hounsfield units. On MR images, 18 cysts were detected. Twelve cysts showed smooth border. Bone expansion was not observed. Most cysts showed intermediate signal intensity on T1-weighted images, and high or nonhomogeneous intermediate/high signal intensity on T2-weighted images with the fat suppression technique. No cyst showed contrast enhancement in both examinations.

CONCLUSION

The CT images revealed bony information, and the MR images clearly demonstrated border of POMC. POMC should be evaluated with both CT and MR imaging.

Post operative maxillary cyst: report of an unusual presentation

A postoperative maxillary cyst is a rare, delayed complication of operations on the maxillary sinus, trauma. or infection, particularly in Japan. As far as we know this is the first reported case in a patient of African origin. The cyst presented as a midline palatal swelling that arose from the nasal, rather than the antral, mucosa. Awareness of this condition will expedite its correct diagnosis and management. In most cases, enuclcation is the treatment of choice.