Maxillary sinus cyst: removal, symptoms, treatment

Causes of maxillary sinus cysts

Predisposing factors for the formation of a maxillary sinus cyst are:

Individual anatomical and topographical features of the structure of the nasal cavity, which impede the free movement of air through the nasal canals (congenital deformities, deviated septum).
Blockage of the excretory duct of the glands located in the mucous membrane of the paranasal sinus. This happens with frequent rhinitis, sinusitis, allergic rhinitis and polyposis.
Inflammatory dental diseases with infection spreading to the root canals. The paranasal sinuses are separated from the roots of the molars and premolars by a thin septum, so infection from pulpitic or periodontitis teeth often causes an inflammatory process in the maxillary sinus.
The formation of a dental cyst, which grows into the maxillary sinus and continues to grow inside it.

The maxillary cyst gradually grows larger, filling the sinus without pronounced clinical symptoms. The presence of a formation can be suspected during exacerbations caused by colds, acute respiratory viral infections, local hypothermia, and decreased immunity.

Treatment

In the process of treating chronic maxillary sinusitis, it is necessary to restore the drainage and ventilation function, remove pathogenic discharge and stimulate recovery processes. To achieve success, broad-spectrum antibiotics (amoxicillin, augmentin, panclave, etc.), anti-inflammatory drugs, vasoconstrictor nasal drops, antihistamines, puncture of the maxillary sinuses to clean rinsing water, or rinsing the paranasal sinuses by moving fluid (vacuum) are prescribed. drainage). If the effect of the prescribed treatment does not occur within a week, treatment should be continued up to surgery in the ENT department of the hospital.

If the rinsing water during puncture of the maxillary sinus is white, dark brown or black, a fungal infection can be suspected. In this case, it is necessary to discontinue antibiotics and carry out antifungal treatment. If you suspect the anaerobic nature of the process, which is characterized by an unpleasant odor of the discharge, a negative result in bacteriological examination of the contents, oxygenation (a high-pressure oxygen treatment method) of the sinus lumen should be carried out.

If long-term drainage is necessary, you need to install a drainage in the sinus and rinse it through it daily (up to 3 times a day). In case of severe local pain, which is confirmed by X-ray examination, and the ineffectiveness of conservative treatment within 3 days, as well as if signs of complications appear, immediate referral to an ENT hospital is indicated to carry out surgical debridement.

Symptoms of a maxillary sinus cyst

A cyst of the maxillary sinus does not have specific symptoms in the early stages; the first complaints appear when the tumor grows significantly (15 mm or more). The intensity of growth is an individual indicator for each patient, as is the severity of symptoms.

The main signs of a cystic formation in the maxillary sinus:

Chronic nasal congestion on the affected side;
Bursting sensations in the cheek area (closer to the eye);
Persistent headaches, poorly controlled by analgesics;
Accumulation of mucus at the back of the throat (especially in the morning);
Intermittent mucous or clear nasal discharge;
Frequent sinusitis with purulent discharge from the nasal passages;
Pain when pressing on the causative tooth, redness and swelling of the gums;
Facial asymmetry with pain in the anterior wall of the sinus.

Infection of the sinus by the odontogenic (that is, through the tooth) route most often develops in sinuses with a wide bottom and deep protrusions of the alveolar process into the jaw. The filling of the sinus with air is important - with moderate pneumatization, the risk of cyst formation is less.

During a diagnostic examination, the doctor identifies a hole in the bottom of the sinus. With an exacerbation of odontogenic sinusitis, sharp-smelling purulent masses are released from the nose, and upon rinsing, crumbly-granular white inclusions are found. An x-ray, as a rule, confirms the diagnosis of a maxillary sinus cyst, after which the doctor draws up a treatment plan.

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Types of operations

If a cyst of the maxillary sinus is detected, it will not be possible to limit oneself to therapeutic measures alone, but there is still a prospect of saving the tooth. The treatment of cysts is carried out by a dentist surgeon, who, based on the clinical picture and instrumental examination data, selects a surgical intervention technique:

Cystectomy is an operation involving excision and curettage of the entire cyst cavity, followed by suturing;
Cystotomy is an operation to excise the anterior wall of the tumor, and the doctor communicates the posterior wall with the oral cavity.

Indications for a specific technique are determined individually and depend on the type of cyst, the size of the neoplasm, and the number of teeth involved in the pathological process. Conservative treatment is possible only in the absence of obvious inflammation, it takes 3-4 months, but during this time the tumor can grow with the appearance of complications. That is why surgical opening of the sinus is considered the most reliable method of treating maxillary and other types of cysts.

Treatment of maxillary sinus cyst

Surgical activities carried out by a dentist in the clinic are aimed at:

Relief of the inflammatory process;
Elimination of the source of infection in the oral cavity;
Removal of the root of a tooth with a cyst or extraction of the entire tooth;
Sinus scraping, antiseptic treatment;
Closing the communication between the oral cavity and the sinus;
Creation of drainage for the outflow of liquid contents through the nasal passage.

First, the doctor determines which tooth caused the inflammatory process in the sinus, and the roots of several teeth may be affected. Using radiographs, the size of the sinus and the location of the cyst are analyzed, and the type of anesthesia is selected (usually local anesthesia with the latest generation of drugs). The surgeon will make every effort to save the tooth if possible. With shallow immersion into the cyst cavity, tooth-preserving operations (for example, root resection) show a good effect. When a tooth is immersed more than 1/3 of its length inside the tumor, it is recommended to remove it in order to prevent relapses of the disease.

The “Smile Factor” uses biocompatible modern materials to fill the cavity of the maxillary cyst, ensuring accelerated tissue regeneration. This tactic allows you to restore the jaw bone in a safe way; the prognosis for the intervention is favorable.

The protocol for working with the paranasal sinuses also includes a consultation with an ENT doctor. Treatment is considered successful when clinical symptoms of the disease disappear and there are no pathological changes in bone tissue on control radiographs.

Rehabilitation, features of care

After surgery, slight discomfort persists for 10-14 days. The turundas are removed from the nasal passages on the third day, and the sutures are removed after a week. Swelling, pain, difficulty breathing are temporary phenomena due to the specifics of the operation and do not require separate therapeutic measures. After removing the tampons from the nose, you should carefully follow the doctor’s instructions regarding rinsing the passages with antiseptics. Antibiotic therapy and instillation of vasoconstrictor drugs are prescribed.

During the first month after surgery it is recommended:

Sneeze and cough gently with your mouth open;
Follow a gentle diet with a predominance of soft foods;
Limit intensive nose blowing;
Avoid active facial movements;
Postpone visiting the bathhouse, sauna, swimming pool;
Do not go under water (even in the bathroom);
Temporarily limit sports training;
Sleep with the head of the bed raised on a comfortable pillow.

After treatment, you should visit the dental clinic once every 3-4 months throughout the year. During examinations, the attending physician monitors the progress of recovery, preventing relapses.

Possible complications

Treatment of a maxillary cyst should be carried out exclusively in a properly equipped clinic. Home measures to “resolve” the tumor are ineffective, and in many cases they contribute to the accelerated growth of the cyst due to improper actions by the patient.

Failure to contact a dental surgeon in a timely manner can result in serious consequences:

Spread of the pathological process to healthy teeth followed by their loss;
Penetration of infection into other air sinuses of the skull;
Melting of the bone by purulent masses with the occurrence of osteomyelitis;
Visual impairment, “double vision” due to compression of the eyeball by the cyst;
Pronounced facial asymmetry with very large sinus tumors;
Pathological fracture of the maxillary bone due to tissue thinning;
Exhausting headaches, respiratory dysfunction, chronic malaise.

The most serious complication of a maxillary sinus cyst is considered to be the spread of inflammation to the membranes of the brain and the brain itself, which is extremely dangerous for the patient’s life.

Preventive actions

The following measures will help prevent the occurrence of a maxillary cyst and minimize the risk of complications with existing tumors:

Sanitation of the oral cavity with competent treatment of teeth and gums;
Timely treatment of ENT diseases (rhinitis, etc.);
Correction of a deformed nasal septum;
Treatment of allergic rhinitis;
Early seeking medical help at the first symptoms of the disease.

Smile Factor doctors have modern techniques for treating jaw cysts of any size. Particular emphasis is placed on the painlessness and safety of the intervention, which is achieved by using proven drugs and consumables.

The patient receives competent advice during the rehabilitation period, so that recovery proceeds with maximum comfort. The exact price of treatment for a dental cyst is determined by the amount of work, type of surgery and other factors.

Diagnostics

Physical and instrumental examinations together with radiation diagnostics (computer and magnetic resonance imaging) and a thorough analysis of the patient’s ENT complaints allow us to make the correct diagnosis. It is necessary to distinguish maxillary sinusitis first of all from trigeminal neuralgia, in which pain appears suddenly and is “burning” in nature. Sinusitis is indicated by the appearance of a strip of pus under the middle concha, after the introduction of vasoconstrictor drugs on the probe, or by the predominance of pain in the sinus area without nasal discharge.

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How is surgery performed for chronic sinusitis?

In many clinics, for prolonged and recurrent inflammation of the maxillary sinus, puncture (puncture) is widely used to evacuate pus and administer drugs.

This manipulation is aimed at relieving acute inflammatory phenomena in the maxillary sinus.

But it is impossible to replace surgical intervention with this type of treatment, since it does not affect the anatomical features that complicate the drainage of the maxillary sinus.

Therefore, this approach is not entirely correct; in most cases, it is impossible to cure chronic sinusitis only with the help of punctures.

Therefore, surgery is still the main method of surgical treatment of chronic and complicated sinusitis, and sinus puncture is considered as a symptomatic measure with a temporary effect.

An operation to treat sinusitis can be carried out in the classical way, with the opening of the maxillary sinus through an incision between the upper gum and lip. These are effective, but very traumatic operations. Currently, surgical treatment of chronic sinusitis in adults is preferred in a minimally invasive way, using an endoscope and a surgical laser.

The choice of surgical technique largely depends on the technical capabilities of the medical center, the experience and skills of the operating doctor.

Kinds

Sinusitis is classified according to different criteria. For example, the duration distinguishes between acute form (less than 3 months) and chronic form (more than 3 months). If the disease in its acute form recurs several times a year, it is referred to as recurrent sinusitis.

Chronic inflammation of the sinuses has varying degrees of morphological changes and can be catarrhal, purulent, polyposis, allergic, necrotic; There are other, rarer options.

Exacerbation of chronic sinusitis refers to the addition of new symptoms and/or increased severity of existing ones.

There are mild, moderate and severe sinusitis. Depending on the affected sinus, sinusitis, frontal sinusitis, ethmoiditis, sphenoiditis or their combinations occur.

Depending on the causative agent of the pathology, the following types of sinusitis are distinguished:

viral, caused by adeno, rhino-, coronaviruses, influenza virus, parainfluenza, respiratory syncytial and other causes of ARVI;
bacterial, most often caused by pneumococcus, moraxella or Haemophilus influenzae; Among this group, sinusitis is distinguished against the background of immunodeficiency, nosocomial (developed during a hospital stay), odontogenic (associated with dental diseases);
fungal, more often occurring during long-term irrational treatment with antibiotics or when affected by highly pathogenic species of fungus, including systemic mycoses.

Treatment of inflammation of the sinuses is carried out taking into account the duration, severity of the disease and its causative agent.

Prevention

To prevent the development of sinusitis, the following preventive measures are recommended:

timely treatment of rhinitis and other conditions accompanied by nasal congestion;
prevention of acute respiratory viral infections, avoidance of contact with sick people, frequent hand washing during the cold season;
quitting smoking, including passive smoking;
for allergic sinusitis – treatment of allergies, courses of allergen-specific immunotherapy;
using humidifiers at home and at work;
vaccination against influenza and pneumococcus;
restorative measures, healthy lifestyle, proper nutrition.

NIKIO Medical Center invites all patients with acute or chronic sinusitis for consultation and treatment. The most experienced doctors work here, using modern diagnostic and treatment techniques. Timely contact with specialists greatly increases the likelihood of a cure for sinusitis, including its chronic forms.