Symptomatic maxillary sinus retention cysts: should they be removed?

OBJECTIVES/HYPOTHESIS: Recently, endoscopic sinus surgery (ESS) endoscopic sinus surgery (ESS) okay? has become the surgical procedure of choice for removing retention cysts from the maxillary sinus. The aim of our study was to determine the relationship between symptomatic relief and ESS with or without endoscopic excision of maxillary cysts.

STUDY DESIGN

Prospective, randomized study.

METHODS

Inclusion criteria were symptomatic maxillary cysts filling at least 50% of the sinus space. We conducted a prospective, randomized study comprising 80 patients. Of the patients, 41 underwent endoscopic ethmoidectomy, middle meatus antrostomy, and excision of the cysts (group A); and 39 underwent ethmoidectomy and antrostomy without cyst detachment (group B). During follow-up an attempt was made to correlate symptomatic failure with type of surgery, computed tomography (CT) score, cyst size, and ratio of cyst size/antral size.

RESULTS

Symptomatic failure occurred in nine cases: four in the group A and five in group B. There was no relationship between success rates and type of surgery, CT score, cyst size, and ratio of cyst size/antral size.

CONCLUSIONS

Endoscopic ethmoidectomy and middle meatus antrostomy without cyst detachment yielded similar outcomes with cyst extirpation through the antrostomy. Our treatment should be aimed in restoring ventilation and drainage of the dependent maxillary sinus.