Abstract
A clinical study was performed investigating 98 patients (110 sides) who underwent sinus surgery for post-operative maxillary cysts at our hospital between January 1985 and December 1999. The patients' mean age was 49.5 years, with a range of 23-73 years. Many of the patients had undergone their initial sinus operation for chronic sinusitis between the ages of 10 and 30 years. The mean period between the initial sinus operation and the surgery for post-operative maxillary cyst was 27.5 years. The length of time between the initial sinus operation and the post-operative maxillary cyst surgery was not significantly correlated with the age at the time of the initial sinus operation. The surgical methods used to remove the cysts consisted of Caldwell-Luc operations on 95 sides and endoscopic endonasal antrostomies on 15 sides. The frequency of endoscopic endonasal procedures has increased in recent years. We evaluated the postoperative CT findings in 15 patients (16 sides) who had undergone the removal of the entire cyst by a Caldwell-Luc procedure.
The postoperative sinus findings following the maxillary cyst surgeries were as follows: 4 reduced and obliterated maxillary cavities, 7 reduced maxillary cavities, 3 reduced maxillary cavities with areas of soft tissue density, and 2 recurrent cysts. These results suggest that removal of the entire cyst dose not always result in occlusion with healing by granulation.
The removal of the entire cyst may not be essential in surgery for post-operative maxillary cysts, but the wall of the cyst should be opened to the middle and/or inferior meatus as far as possible. We speculate that endoscopic endonasal procedures will be increasingly used in the future.
