Among the pathologies of the paranasal sinuses are frequently encountered benign tumors in most cases are not causing much concern to the patient. Their endoscopic removal or surgery are performed on an outpatient basis using local anesthesia. In this article we’ll look at the symptoms and treatment of one of varieties of such pathology.
Cyst of the maxillary sinus is a benign volumetric education with an internal cavity that is found in 10% of cases of examination for diseases of the maxillary sinuses. Education can have variable character, different origins and causes, can consist of various tissues (mucous cells, fibrous fibers), have a blank or filled with pus or fluid cavity.
First, let’s talk about common types of pathological changes and the likely causes.
Retention cyst of the maxillary sinus or about the structure
Distinguish true and false cysts of the maxillary sinuses. True cysts are formed when the blockage of ductless glands of the mucous membrane of the nasal passages and sinuses. The gland secretion (mucus) accumulates continually with no way out and around it formed a capsule of epithelial tissue. This so-called retention cysts of the maxillary sinus, which gradually increases and fills the space of the maxillary sinuses. Usually a blockage of the cysts occurs with prolonged and poorly treat chronic sinusitis.
False cysts of the maxillary sinus are entities from other tissues. They often have a dental origin and develop from fibrous or bone tissue, and can also be presented in the form of cholesteatoma, or keratocyst containing cholesterol crystals, Horny structures and the epithelium. Predisposing factors in this case are chronic inflammation of the periodontium, dental caries, severe chronic illness.
Odontogenic cyst of the maxillary sinus
Odontogenic cysts of upper jaw, i.e. a cavity, which is formed from tissues of the tooth, is a false form. It is usually located in the lower parts of the maxillary sinus is formed when the dental disease of the tissue of the follicle.
The location is isolated lesions of the left and right sides as well:
- Cutting holes (naseeba);
The most common form of all types of cysts of maxilla and mandible – radicular. It is formed from structures of the tooth root after the transferred inflammatory process with formation of granulomas. Usually its size does not reach more than 1 cm, but sometimes there are large – up to 3 cm, She is thin, composed of fibrous tissue, in which are plasma cells and lymphocytes, lined inside with stratified epithelium. The inflammation leads to hyperplastic processes development processes directed inside the capsule.
In the complete melting of the epithelium of the cavity of the education can be completely filled with granulomatous tissue. These tumors have a tendency to fester, can cause destruction of the adjacent bone tissue, bony plates. Inside the cavity can be detected in foam cells, cholesterol crystals. The location of radicular cysts can lead to marginalization or extension into maxillary sinus.
Retromolar is a cyst that forms during the growth of wisdom teeth.
Nasoalveolar occurs in the region of the junction of the maxilla and nasal bone on the border of three processes (nasal, frontal, maxillary). Such a tumor is formed in the soft tissues and can be lined by any epithelium: flat, cylindrical, transitional, cubic.
Cyst of the incisal canal with the gradual growth destroys the Palatine bone may be lined by flat or cylindrical epithelium.
Follicular occurs because of immature enamel of incisors, molars and premolars, and may include one or more of the rudiments or teeth formed teeth. Its thin capsule is composed of flat cells of stratified epithelium.
Globalagenda is formed between the canine and lateral incisor, grows slowly and can grow into the cavity of the nose or upper jaw. The fluid contains cholesterol crystals, and the cavity is lined with flat, cylindrical or cubic epithelium.
The probable causes of pathology studied enough
The mechanisms of pathology are studied enough by science and doctors have a detailed understanding of all trasformation tissue under the influence of the probable causes. A true cyst of the maxillary sinus can be formed due to the curvature of the nasal septum and the inflammatory process (sinusitis). In the first and in the second case there is an obstacle to the outflow of mucous secretion of the glands, causing the formation of a tumor.
About tumors arise from the proliferation of granulomatous tissue due dental disease.
The probable reasons are complemented by predisposing factors, which serve allergic processes and inflammation, infection and metabolic disorders, hypovitaminosis, immune deficiency.
Signs and symptoms that you should pay attention
In the initial stage of development of the cyst in maxillary sinus symptoms does not, but there are signs that you should pay attention to timely examinations. At first it can be a small elevation above the surface of the upper jaw, locating near to the tooth, if this odontogenic pathology. And if it is a true cyst, the symptoms will resemble a clinical picture of sinusitis: headache and jaw pain from the affected side, congestion as with a cold, chronic rhinitis.
Odontogenic development of education of patients suffers from pain while chewing and biting. If the tumor has reached a visible size, in the upper jaw or in the nose can be palpable painless rounded education of different density. When suppuration in the field of education will be swelling and inflammation, pain when touched.
When you close the location of the tumor near the exit of the second branch of the trigeminal nerve, i.e., in the upper part of the air sinus, and even the small size of tumor will lead to significant pain. In this large cyst in her lower parts can be painless. In addition, persons who are fond of scuba diving, the disease causes discomfort and headaches when diving at depth.
If there is a showdown, then from the nasal cavity from the tear fluid, filled cyst.
To confirm the diagnosis of true or false cysts of the maxillary sinus must be done renthenznimky or a CT scan of the sinuses. In the picture it is possible to determine the location, size, shape and character of the surrounding bone structures.
Methods of treatment of cysts of the maxillary sinuses: surgery or endoscopic removal
If the diagnostics detected cysts of the maxillary sinuses, the treatment of such entities can be only surgical. And the sooner treatment is begun, the sooner will come the recovery. Better not to bring the disease to complications and trauma surgery techniques. The most common methods of treatment are surgery or endoscopic removal of tumors without skin incisions.
If allows localization and small size of the cyst, the method of choice may be endoscopic removal of the cyst of the maxillary sinus. This is the most forgiving operation, which does not require special training and special management of the postoperative period.
The intervention does not require incisions and special accesses through the natural Airways. The nasal passage and later in anatomic communication with the maxillary sinus inserts a thin probe, which monitored complete the transaction. If a patient does not require registration in the hospital – he goes home three hours after surgery.
In any case, if there is a tumor, the operation is carried out according to individual indications with all the age and physiological characteristics of the organism. The smaller the formation, the less post-operative trauma and complications.
Classic surgery to remove tumors
Classic surgery to remove cysts of the maxillary sinus, which occurs in most clinical cases, is to perform an incision on the upper jaw in the region of the transition on the upper lip. Further incising the anterior wall of the maxillary sinus and removed the internal education, saneroite sinus cavity. Little postoperative defect in the region of the bone wall does not require fill and eventually overgrown.
There are two types of surgical intervention:
Cystostomy shown in the existing duration of the current chronic diseases, the incidence of cyst of bone structures or several teeth. In this case, a puncture and a drainage of the contents. The capsule remains intact. In cases of suppuration of education requires a constant outflow and drainage of the cystic cavity. For this after surgery not sutured wound, and leave a message with the oral cavity.
Cystectomy is complete removal, together with the capsule and epithelium, to prevent recurrence of the growth of education. Cystectomy is indicated in the absence or loss of teeth in the area of operations, the capture of two teeth in the pathological process, the size of the cyst 7mm or more. To strengthen bone structure and prevent re-growth after surgery, the remaining cavity is filled with a special material. If the cyst captures one-third of the tooth root, it is possible resection or incision. In other cases, the affected tooth is removed.
After removal of the cyst of the maxillary sinus in some cases, the tumor grows again. It depends on the quality of the performed operation, and the individual characteristics of the organism. Therefore, after the operation it is advisable to cure chronic infections of the upper respiratory tract, dental caries, periodontitis, sinusitis, chronic runny nose, correct a deviated septum, which contribute to the recurrence of the disease.
To do this, you must also always be seen by a dentist and Laura and the time to pass assigned examinations and treatment, maintain a healthy lifestyle and proper nutrition.