Mucosal maxillary cysts (MMCs) are usually asymptomatic and are often diagnosed as an incidental finding. The aim of this study is to assess clinical significance of MMCs and the long-term effect of surgical treatment on the symptoms initially addressed to MMCs. The study included a retrospective analysis of 64 patients who had undergone surgery for MMC using a questionnaire focused mainly on the effect surgery had on symptoms. Mean time of follow-up was 79 months. Patients were also divided and compared according to the presence of rhinitic symptoms. Twenty-six patients (63.4%) reported complete disappearance of symptoms, 8 (19.5%) reported improvement, 4 (9.7%) reported no change in symptoms following surgery and 3 (7.3%) reported that symptoms reappeared. Significantly (p = 0.0365) better results were achieved in patients without preexisting rhinitic symptoms. This study supports the opinion that in some cases, MMCs are involved in the development of sinonasal symptoms. Surgical treatment leads, in most patients, to disappearance or improvement of symptoms and the effect is better in patients without rhinitic symptoms.
We present the clinical, radiological and pathological features of a case of a cranial hypertrophic pachymeningitis that developed in the course of mastoiditis and petrous apex inflammation and responded to immunosuppressive therapy only. Documented by the development of clinical findings, magnetic resonance imaging, cerebrospinal fluid changes, histopathology findings, by otosurgical intervention and finally by the insertion of a ventriculo-peritoneal shunt, the case illustrates a gradual development of pachymeningitis with consequent hydrocephalus and intracranial hypertension. We consider this disease development an example of immune-induced proliferative fibrotic changes in meninges.
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