Ramakrishnan Divya Sanjeevi, Abdul Wahab P U, Dhasarathan Pradeep, Madhulaxmi M, Kandamani Janani
Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India.
Ann Maxillofac Surg. 2020 Jul-Dec;10(2):479-483. doi: 10.4103/ams.ams_284_20. Epub 2020 Dec 23.
Surgical ciliated cyst (SCC) is a type of true epithelial lined antral cysts, which mostly occurs in maxilla from the sinonasal mucosa and gland, comprising 20% of all oral cysts in Japan. It is also called as postoperative maxillary cyst or postoperative paranasal cyst. The etiology is believed to be post trauma or surgery in the region of maxillary antrum.
Patient's concern is less evident in this cystic pathology, because this cyst even though an aggressive cyst, presents with fewer symptoms that can be uncomfortable to the patient or push them to seek medical attention. Often, this becomes an incidental finding during routine postoperative follow-up.
The rationale behind this report is to emphasize even a traumatic extraction of tooth can damage the floor of the sinus and lead to the cyst formation.
We report a case of SCC in a 76-year-old female of the left maxillary sinus possibly after a traumatic extraction of the tooth, for which enucleation of the cyst was done as a primary modality of treatment.
Diagnosis was made after a computed tomography (CT) scan and incisional biopsy. Diagnosis of such rare cases poses a great challenge due to its paucity in etiology, and it often requires a CT scan that becomes an essential gold standard investigation.
Patient is currently under one year follow up and without any signs of recurrence.
It should be acknowledged that tampering trauma or with sinus mucosa can trigger the formation of a SCC of the maxilla, and it should always be considered as a possible sequel after any procedure of such potential in the maxilla.
外科性纤毛囊肿(SCC)是一种真正的上皮内衬鼻窦囊肿,大多发生于上颌骨的鼻窦黏膜和腺体,在日本占所有口腔囊肿的20%。它也被称为术后上颌囊肿或术后鼻旁囊肿。病因被认为是上颌窦区域的创伤或手术。
在这种囊性病变中患者的相关情况不太明显,因为这个囊肿尽管具有侵袭性,但症状较少,不会给患者带来不适或促使他们就医。通常,这是在术后常规随访中偶然发现的。
本报告背后的基本原理是强调即使是外伤性拔牙也可能损伤鼻窦底并导致囊肿形成。
我们报告一例76岁女性左上颌窦的SCC病例,可能是外伤性拔牙后所致,对该囊肿进行了摘除术作为主要治疗方式。
通过计算机断层扫描(CT)和切开活检后做出诊断。由于这种罕见病例病因稀少,诊断面临巨大挑战,通常需要CT扫描,这已成为必不可少的金标准检查。
患者目前正在接受为期一年的随访,没有任何复发迹象。
应该认识到对上颌窦黏膜的外伤性损伤或干预可能引发上颌骨SCC的形成,在对上颌骨进行任何此类有潜在风险的手术后,都应始终将其视为一种可能的后遗症。