Respiratory implantation cyst of the mandible following orthognathic surgery

Abstract

A cyst following implantation of respiratory epithelium during surgical procedures has been documented only rarely. A variety of names have been attached to this lesion: respiratory mucocele, respiratory implantation cyst, surgical ciliated cyst, and surgical (implantation) cyst. In seven prior case reports, the interval between the initiating surgical procedure and diagnostic biopsy of the resultant well-circumscribed radiolucency and histopathological demonstration of distinctive pseudostratified ciliated columnar epithelial lining has varied from 4 to 40 years. In the case reported here, chin augmentation used “residual maxillary bone” as the donor tissue and likely transplanted sinonasal mucosa into the mandible during orthognathic surgery, resulting in a painful anterior mandibular cyst lined by respiratory epithelium that was ablated 16 years later.

Surgical ciliated cyst of the mandible after orthognathic surgery: a case report with review of the literature

“…Mandibular surgical ciliated cysts, however, are preceded by simultaneous surgery on the maxilla and mandible, such as chin augmentation with septal cartilage or bimaxillary orthognathic surgery. Of the 16 cases reported, 8 developed after nasal cartilage and bone transplantation, which supports the hypothesis that respiratory epithelium attached to the graft and transferred to the surgical site gives rise to surgical ciliated cysts [15].…”

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

“…After performing a literature review on the surgical ciliated cyst of the mandible, we found 12 clinical cases [2,[8][9][10][11][12][13][14][15] (Table 1). The age of patients ranged from 33 to 59 years (mean: 36.9 ± 13 years), and males and females were equally affected.…”

“…The presence of respiratory epithelium in the upper maxillary odontogenic cysts (radicular cyst, dentigerous cyst, odontogenic keratocyst) is uncommon [16,17]. Regarding the surgical ciliated cyst, the use of bone grafts from the maxilla and/or nasal cartilage could explain the presence of the ciliated pseudostratified epithelium [8,12,18,19]. In the cases without grafting, the transplantation of respiratory epithelial rests during the bimaxillary surgical procedure is the etiopathogenic hypothesis more frequently considered [2, 14-16, 20, 21].…”

Surgical ciliated cyst of the maxilla after orthognathic surgery: A case report

“…Surgical ciliated cyst (SCC), also known as postoperative maxillary cyst, paranasal cyst, or respiratory implantation cyst, was first described by Kubo in 1927 in the Japanese literature (1) as a maxillary cyst after treatment of chronic maxillary sinusitis. In the Japanese population, this lesion accounts for up to 20% of maxillary cysts (2), being the largest published series of 71 cases of postoperative maxillary cysts (3). However, to date, few reports have been published in the English literature on non-Asian populations (4).…”