Patient management with maxillary sinus cysts

Abstract

Cystic lesions of the maxillary sinuses include cysts, polyps and neoplasms. Maxillary sinus cysts are benign lesions that are commonly an incidental finding during X–ray, since any symptoms do not accompany their presence. An urgent problem is the development of differential diagnostics, the determination of indications for surgical treatment and the optimal treatment tactics for patients with cystic lesions of the maxillary sinuses. The authors describe their experience in patient management with maxillary sinus cysts. 175 patients (mean age — 44.93 years) with lesions in the maxillary sinus were examined and surgically operated. All patients underwent a comprehensive clinical examination aimed at a differential diagnosis of maxillary sinus pathology: cysts, polyps and neoplasms. All patients underwent endoscopic endonasal surgery: in 135 cases it was conducted via the inferior nasal meatus, in 40 patients — via the middle nasal meatus due to the large size of the cyst. Histology confirmed the established diagnosis during the clinical and instrumental examination. The postoperative period proceeded with no abnormalities. After 6 months, the patients underwent a control computed tomography of paranasal sinuses. In all cases, there was a complete cyst removal and restoration of sinus pneumatization. Thus, the differential diagnosis concerning cystic lesions of the maxillary sinus should be based on clinical manifestations and the results of X-ray techniques and follow-up of patients with scanty symptoms and signs. The optimal treatment method of maxillary sinus cysts is the endoscopic endonasal approach, followed by morphological examination. KEYWORDS: benign lesion, maxillary sinus cyst, cystic lesion, differential diagnosis, endoscopy, endoscopic endonasal approach. FOR CITATION: Karpishchenko S.A., Zernitsky A.Y., Vereshchagina O.E. et al. Patient management with maxillary sinus cysts. Russian Medical Inquiry. 2022;6(7):411–415 (in Russ.). DOI: 10.32364/2587-6821-2022-6-7-411-415.