Endoscopic Modified Medial Maxillectomyアプローチにより開窓された術後性上顎囊胞例

抄録

Postoperative maxillary cysts are lesions that occur after Caldwell-Luc surgery. For the cysts that are widely in wide contact with the lateral wall of the nasal cavity, fenestration can be performed using a standard endoscopic sinus surgery procedure. It has been reported that it is important to cover the fenestrated bone wall with a mucosal flap to prevent reclosure of the cyst wall. In recent years, there have been reports of application of the endoscopic modified medial maxillectomy (EMMM) approach for various maxillary sinus lesions.

Herein, we report a case of performing surgery using the EMMM approach for a patient with a postoperative maxillary cyst. The patient was a 60-year-old woman who presented with the chief complaint of right cheek pain. She gave a history of having undergone bilateral Caldwell-Luc surgery at the age of 15 years. Computed tomography revealed the presence of bilateral maxillary postoperative maxillary cysts. The cyst on the left side was in contact with the lateral wall of the inferior meatus, whereas the cyst on the right side located cranially, lateral to the nasolacrimal duct, showed almost no contact with the inferior meatus. We performed fenestration using the EMMM approach for the cyst on the right side using a navigation system. The fenestration was covered with a middle meatal mucosal flap to prevent cyst reclosure.

Until now, 6 months since the surgery, the cheek pain has not recurred, and CT showed that the cyst cavity opened into the middle meatus.