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

Abstract

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.”

Surgical ciliated cysts of the mandible: A systematic review of case reports

“…One article reports a bimaxillary osteotomy surgery without genioplasty (Koutlas et al., 2002). Only one case was presented as unrelated to a major maxillofacial surgery (Lafuente‐Ibáñez de Mendoza et al., 2021). Surgical ciliated cysts of the mandibular region show a 1.25:1 male‐to‐female ratio.…”

“…In 1994, Nastri and Hookey (1994) described for the first time a mandibular localization. Since then, 14 publications about mandibular surgical ciliated cysts have been published for a total of 16 cases (Anastassov & Lee, 1999; Bourgeois & Nelson, 2005; Cai et al., 2015; Drmeddent & Schwartz, 2001; Kelly et al., 2000; Koutlas et al., 2002; Lafuente‐Ibáñez de Mendoza et al., 2021; Lazar et al., 2006; Li et al., 2014; Ragsdale et al., 2009; Seifi et al., 2016; Syyed et al., 2018; Youn et al., 2022). This article reports the 17th and 18th cases of mandibular surgical ciliated cysts in twin sisters who underwent genioplasty with concomitant rhinoplasty 30 years earlier.…”

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

“…Furthermore, to prevent the sinonasal epithelium from being transferred to the mandible by the surgical instrument, it would be advantageous to clean or replace not only the cutting saw but also other surgical instruments, such as drill bits and chisels. In only 1 of the 16 cases—the one published most recently before our report—a mandibular surgical ciliated cyst was observed after grafting of platelet-rich plasma on the extraction socket, without simultaneous maxilla and mandible surgery [ 8 ]. Those authors assumed that the cyst was caused by growth factor in the platelet-rich plasma, but this was the only such case, and more research on the causes is needed in the future.…”

“…They have respiratory-type epithelium lining inside, and the presumed cause is infiltration of the mucous membrane of the maxillary sinus by an instrument during surgery [ 6 ]. Surgical ciliated cysts in the mandible are very rare; only 15 cases have been reported in English-language journals so far [ 2 – 4 , 7 , 8 ]. We report a 16th case of surgical ciliated cyst in the mandible, presumed to have occurred after orthognathic surgery and genioplasty performed 24 years earlier.…”

Maxillary Postsurgical Ciliated Cysts (PSCCs): A Series of Three Cases

“…Simultaneous surgical procedures involving both the maxilla and mandible, utilizing the same instruments, have been implicated in the mandibular PSCC development [28]. It can occur anteriorly in the chin region in patients who underwent bone genioplasty after LeFort I osteotomy, or more posteriorly, in the sagittal split osteotomy region, following bimaxillary orthognathic surgeries [29,30].…”