Transnasal endoscopic surgery of post-operative maxillary cysts

Sawatsubashi, Motohiro; Murakami, Daisuke; Oda, Mari; Komune, Shizuo

doi:10.1017/s0022215114002382

Cited by 9 publications

(15 citation statements)

References 14 publications

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“…Previously, surgical approaches that have been used for POCC were primarily open approaches, such as the C-L surgery. Endoscopic marsupialization has become the treatment of choice for POCC due to the development of new instruments and image-guided systems [13]. However, an effective marsupialization of cysts located far from the lateral nasal wall is difficult when an endonasal endoscopic approach is used.…”

Section: Discussionmentioning

confidence: 99%

“…The other is an intranasal approach involving complete marsupialization using the recent advanced trans-nasal endoscopic approach along with middle meatal antrostomy (MMA) or inferior meatal antrostomy (IMA). However, if the location of the POCC is far anterior or lateral or if the bony wall of the inferior meatus is too thick, the marsupialization of the lesion can be performed via conventional surgery using the canine fossa approach (also known as the C-L approach) along with IMA at the end of the procedure to secure an internal (endonasal) drainage [6,7,10-13].…”

Section: Introductionmentioning

confidence: 99%

“…Recently developed instruments, including the surgical drill and navigation system, have expanded the indications for endoscopic endonasal surgery that make it possible to manage certain sinonasal mucoceles that are anatomically difficult to access using the endoscopic endonasal approach alone. However, even after performing surgical drainage via endoscopic marsupialization, POCC may recur in 2%–38% of patients [13]. In addition, patients may still complain about residual symptoms, such as cheek pain and repeated cheek swelling even after surgical treatment and medication.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Principal Clinical Factors Predicting Therapeutic Outcomes After Surgical Drainage of Postoperative Cheek Cysts: Experience From a Single Center

Cho

Lim

Song

et al. 2019

Clin Exp Otorhinolaryngol

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ObjectivesPostoperative cheek cyst (POCC) is a late postoperative complication of radical maxillary sinus surgery including the Caldwell-Luc (C-L) operation. The present study aimed to evaluate the therapeutic outcomes of surgical treatment for POCC and to assess the clinical factors correlated to these outcomes.MethodsThis study included 57 patients (67 nostrils) diagnosed with POCC who underwent surgical drainage. The medical records of the patients were retrospectively reviewed for radiological findings, treatment modalities, residual symptoms, and recurrences.ResultsIn total, 30 patients were male and 27 patients were female with a mean age of 55 years, and the patients were usually diagnosed with POCC 28.2 years after radical surgery. Endonasal endoscopic marsupialization was performed via inferior meatal antrostomy, and if possible, middle meatal antrostomy was performed at the same time. In patients with cysts that were difficult to reach using an endonasal endoscopic approach, additional open C-L approaches were performed. The median follow-up period was 19.4 months. Overall, adequate drainage and symptomatic relief were achieved in 91% (61/67) of the patients. The recurrence rate was significantly higher in patients who had anterolateral POCC. Failure to achieve symptomatic relief was correlated to a smaller cyst and the use of the open C-L approach for drainage.ConclusionThe location and size of the cyst as well as the use of the open surgical approach were important factors in predicting the therapeutic outcome of POCC. The time point of treatment and surgical approaches should be based on the above-mentioned findings.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Principal Clinical Factors Predicting Therapeutic Outcomes After Surgical Drainage of Postoperative Cheek Cysts: Experience From a Single Center

Cho

Lim

Song

et al. 2019

Clin Exp Otorhinolaryngol

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“…Most reports on POMCs are from East Asian regions such as Japan, Korea, and China [1-6]. POMC develops approximately 15–20 years or more after the initial operation and the symptoms include cheek pain, cheek swelling, diplopia, and nasal obstruction.…”

Section: Introductionmentioning

confidence: 99%

“…These endoscopic methods are proven to be physiologically effective, less invasive methods for the treatment of POMCs [2-6, 9, 10]. The major risks involved in the endoscopic endonasal marsupialization of POMCs include postoperative pain, postoperative bleeding, lacrimation by stenosis of the nasolacrimal duct, and paresthesia of the upper molar region due to damage to the alveolar nerve [11, 12].…”

Section: Introductionmentioning

confidence: 99%

Infraorbital Nerve Located Medially to Postoperative Maxillary Cysts: A Risk of Endonasal Surgery

Kondo¹,

Baba²,

Suzuki³

et al. 2018

ORL

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Background/Aims: This study aimed to examine variations in the location of the infraorbital nerve relative to postoperative maxillary cysts to assess the potential risk of nerve injury during endonasal marsupialization. Methods: Coronal computed tomography images of 130 patients (162 sides) with postoperative maxillary cysts who visited our clinic between 2003 and 2014 were reviewed from the viewpoint of the anatomical relationship between the infraorbital nerves and cysts. Results: The proportions of the six locations were as follows: upside 45.1% (n = 73), separate 13.0% (n = 21), medial 5.6% (n = 9), lateral 14.2% (n = 23), in-between 7.4% (n = 12), and unevaluable 14.8% (n = 24). The proportion of the cases with a potential risk of infraorbital nerve damage during endoscopic marsupialization, including medial, in-between, and unevaluable locations, was 27.8%. Retrospective chart review revealed that 2 patients with a postoperative maxillary cyst that were unevaluable complained of persistent postoperative hypoesthesia of the cheek. Conclusion: The anatomical relationship between the infraorbital nerve and postoperative maxillary cysts varied among patients, with approximately one-fourth of the patients being at risk of infraorbital nerve injury even during endoscopic procedures.

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A Covered Lateral and Posterior Wall Flap of the Maxillary Sinus Prevents Reocclusion of the Postoperative Maxillary Cyst

Aoki

Omura

Miyashita

et al. 2021

Indian J Otolaryngol Head Neck Surg

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Although the number of postoperative maxillary cyst (POMC) cases has declined recently, a few reports of refractory cases have also been reported. The indications for endoscopic sinus surgery (ESS) for POMC removal are broadening and attempts to prevent postoperative recurrence at the cyst opening site have been widely investigated. Here, we have advocated our original pedunculated mucoperiosteal flap (CLAP flap; covered lateral and posterior wall flap of the maxillary sinus), where the bony area exposed intraoperatively is covered, to prevent postoperative recurrence. We have also presented the method for creating the CLAP flap. We classified the POMC as being medial, lateral, or anterior superior type and performed ESS. We introduced the CLAP flap after 2015 for the lateral type and some of the medial types of POMCs. We examined the cyst opening rate using computed tomography, age, sex, cyst position, and a follow-up period in four patients (five sides) who did not undergo flap surgery, but who were managed in our hospital in 2015, and in eight patients (nine sides) who underwent the CLAP flap technique in our hospital. In the group with the CLAP flap, the cyst opening rate was significantly higher (P \ 0.05). The CLAP flap was effective for preventing postoperative bony regrowth. It may be one of the options for covering the exposed bone surface as widely as possible.

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Transnasal endoscopic surgery of post-operative maxillary cysts

Abstract: Transnasal endoscopic surgery is an effective treatment for post-operative maxillary cyst with the exception of cysts located distant from the nasal cavity.

Cited by 9 publications

References 14 publications

Principal Clinical Factors Predicting Therapeutic Outcomes After Surgical Drainage of Postoperative Cheek Cysts: Experience From a Single Center

Principal Clinical Factors Predicting Therapeutic Outcomes After Surgical Drainage of Postoperative Cheek Cysts: Experience From a Single Center

Infraorbital Nerve Located Medially to Postoperative Maxillary Cysts: A Risk of Endonasal Surgery

A Covered Lateral and Posterior Wall Flap of the Maxillary Sinus Prevents Reocclusion of the Postoperative Maxillary Cyst

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