Endoscopic sinus surgery for the odontogenic maxillary cysts

Abstract

To evaluate the effectiveness and usefulness of transnasal endoscopic surgery for the treatment of odontogenic maxillary cysts. Methods: Between February 2003 and February 2008, transnasal endoscopic surgery was performed under general anesthesia in 13 patients (male 6 and female 7, 19 to 75 years old) with odontogenic maxillary cysts that extended to the maxillary sinus. Ten patients had a radicular cyst and three patients had a dentigerous cyst. After the resection of anterior edge of the inferior turbinate, the lateral wall of the inferior nasal meatus was opened. Then, the cyst wall of the maxillary sinus was partially or completely removed under the endoscope. Results: The cyst walls were completely removed in five of ten patients with a radicular cyst and in all three patients with a dentigerous cyst. Five patients with a radicular cyst received partial resection of the cyst wall. The affected teeth could be preserved in seven of ten patients with a radicular cyst and in one of three patients with a dentigerous cyst. There were no complications, and postoperative courses were uneventful. Follow-up period ranged from 11 to 72 months (mean 42 months), and no recurrence has been noted in any of the cases. Conclusions: Endoscopic transnasal surgery for the odontogenic maxillary cyst is less invasive than conventional dental approach, and most of the affected teeth can be preserved. This technique appears to be a simple and highly effective surgical treatment for the treatment of patients with odontogenic cysts that extend to the maxillary sinus.

An odontogenic cyst causing facial asymmetry: a case report

“…As radicular cysts generally show growth without pain, facial asymmetry which forms as a result of deformation of the alveolar structure, may sometimes emerge as the first finding. In large cysts, as the bone wall has become very thin and fragile and the sound of crepitation in the form of 'cracking eggshells' can be obtained on palpation of the alveolar bone vestibular wall [1,2,4,5].…”

Quiste dentígero asociado con un diente ectópico en el seno maxilar: Reporte de un caso y revisión de la literatura

“…Puede ser necesaria la ayuda ortodóntica para permitir que el diente entre en erupción totalmente. Lesiones más extensas, especialmente ésas con proximidad a las estructuras vitales, o en pacientes médicamente comprometidos se pueden tratar por Marsupialización, reduciendo al mínimo la necesidad de una cirugía más radical (18)(19)(20)(21).…”

Endoscopic modified medial maxillectomy for odontogenic cysts and tumours

“…Otorhinolaryngologists have recently reported the successful endoscopic resection of odontogenic cysts and tumours when there is minimal extension into the maxillary sinus (2,5,6) . However, if the disease should occupy most of the maxillary sinus, enucleation is not possible.…”

“…As the indications for endoscopic sinus surgery have expanded, there have now been several reports of odontogenic cysts and tumours being treated endoscopically (2,5,6) . However, it is not always possible to completely enucleate the lesion in every case using this technique alone.…”

“…Incomplete removal of the cystic lining may reflect technical difficulties encountered during excision, but risks recurrence (1) . Dentigerous cysts should also be completely resected (2) , while marsupialisation is considered to be acceptable for radicular cysts (3) . Nevertheless, it is sometimes difficult to discriminate between keratocystic odontogenic tumours and radicular cysts before surgery (4) ; consequently our clinical practice is to completely excise the lesion in all such cases.…”