Imaging Sci Dent.  2014 Dec;44(4):321-324. 10.5624/isd.2014.44.4.321.

Bilateral postoperative maxillary cysts after orthognathic surgery: A case report

• Lee JH
• Huh KH
• Yi WJ
• Heo MS
• Lee SS
• Choi SC

• KMID: 1974502
• DOI: http://doi.org/10.5624/isd.2014.44.4.321

Abstract

Postoperative maxillary cysts are locally aggressive lesions, usually developing as delayed complications many years after radical antral surgery. This report describes a case of bilateral postoperative maxillary cysts following orthognathic surgery performed approximately 21 years previously. The patient complained of stinging pain on her right cheek. Radiographic examination revealed low-attenuation lesions on both maxillary sinuses with discontinuously corticated margins without distinct expansion or bone destruction. The cysts were enucleated with the removal of metal plates and screws for pain relief. Histopathological examination confirmed the diagnosis of postoperative maxillary cysts lined by ciliated, pseudostratified columnar cells. The patient has remained asymptomatic thus far, and there was no evidence of local recurrence at 21 months of postoperative follow-up.

Keyword

Maxillary Sinus; Orthognathic Surgery; Cysts; Radiography

MeSH Terms

Bites and Stings
Cheek
Diagnosis
Follow-Up Studies
Humans
Maxillary Sinus
Orthognathic Surgery*
Radiography
Recurrence

Figure

• 

  Fig. 1 A. Panoramic radiograph shows dome-shaped homogeneous radiopacities at the lower regions in both maxillary sinuses. There are metal plates, screws in the maxilla, and wires on the mandible from the previous orthognathic surgery. B. Waters' radiograph shows increased haziness at the lower regions in both maxillary sinuses, but there is no distinct expansion or bone destruction.

• 

  Fig. 2 Computed tomography images show low-attenuation lesions in both maxillary sinuses. A. Axial image reveals no distinct expansion and bone destruction of the lesions. Postoperative signs such as antral wall thickening, sclerotic change, and loss of continuity of the cortical antral wall lining are not seen. B. Coronal image shows that the lesions extended slightly below the floor of both nasal sinuses. C and D. Sagittal images of right (C) and left (D) maxillary sinuses reveal the undulated margins, which were discontinuously corticated.

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  Fig. 3 A. Histopathological examination shows the inflammatory cells infiltrating around the cystic cavity (H&E stain, 40×). B. The cyst is lined by ciliated, pseudostratified columnar cells (H&E stain, 400×).

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