Maxillary sinus cyst - symptoms and treatment

General information

Before considering the symptoms and treatment of this pathology, you must first understand what a maxillary sinus cyst is and why it appears in the first place.

At its core, a cyst is a bubble containing pathological fluid. In the maxillary cavities, this formation appears due to a violation of the outflow of secretions from the glands, which are located on the mucous membranes that cover the entire inner surface of the sinuses.

Depending on the factor that provoked the disruption of the outflow of glandular secretions, the fluid located inside the maxillary sinus cyst may be purulent or serous. In some cases, it may be completely absent, and instead the formation may be filled with ordinary air.

Important! During diagnostic measures, it is very important to establish what exactly the tumor is filled with, since further treatment of the maxillary sinus cyst depends on this.

Comments

The other day I visited LORA, because... I'm worried about constant nasal congestion. HE examined and diagnosed “odontogenic sinusitis” and prescribed symptomatic treatment. He said that in order for everything to return to normal, you need to go to the dentist and look for the cause. No cyst was found. Explain what could be the reason and why this is dangerous?

Tanyusha (06/03/2020 at 17:53) Reply to comment

Editorial staff of the portal UltraSmile.ru (06/08/2020 at 09:16) Reply to comment

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Varieties

Depending on the cause of occurrence and the nature of the contents, a cyst in the maxillary sinus can be:

retention or true;
pseudocyst or false.

The difference between these formations is that the true ones, both outside and inside, are completely covered with a mucous membrane, which also contains glands that continue to produce secretions. A false cyst of the maxillary sinus does not have mucous membranes inside, and therefore it does not have the property of progressive growth, since the accumulation of secretions does not occur in it.

It should also be noted that such formations are divided into right-sided and left-sided. A cyst of the left maxillary sinus is as common as the right one. But bilateral sinus damage is extremely rare.

What can a cyst of the maxillary sinus lead to?

The disease develops unnoticed, without any manifestations. The patient may not know for a long time that the disease is progressing.

Important! As a retention tumor progresses, the gland produces fluid, which causes the formation to grow and stretch the walls. The tumor is usually located outside the paranasal sinus.

With rapid magnification, it thins the walls, which can be clearly seen with an x-ray. To prevent the development of the disease, it is necessary to observe preventive measures to prevent viral diseases and promptly treat acute respiratory viral infections and runny nose.

The lack of adequate therapy in the treatment of cysts of the paranasal cavity is dangerous and can lead to serious consequences. As the tumor progresses, it affects almost all organs in the human body; in an advanced situation, a person faces death. What else does this disease threaten?

From the respiratory tract – the nose is often stuffy, the patient develops bronchitis, tonsillitis, sinusitis.

Danger threatens if a person’s brain is damaged. Symptoms: migraine, convulsions in the lower extremities, vomiting, coma and pale skin.

Other internal organs may be affected - the heart, kidneys, liver, intestines, muscles and joints of the body.

Etiology

As mentioned above, a cyst in the maxillary sinus begins to form against the background of obstruction of the gland ducts. They are located on the mucous axillary cavities and are involved in the production of mucous secretion, which has anti-inflammatory and antibacterial effects.

Secretion production increases when a person becomes ill with inflammatory or viral diseases. And when this happens too often, due to excessive secretion production, the excretory ducts become clogged and the glands stop functioning, but fluid production continues. And since it is not excreted, the walls of the gland begin to gradually stretch and a bubble forms - a cyst of the maxillary sinus.

The reasons for the activation of secretion production by the glands and the further formation of a maxillary cyst are:

Sinusitis.
Sinusitis.
Inflammatory and infectious diseases of the oral cavity (the maxillary sinuses are located close to the oral cavity, and therefore any processes occurring in it easily spread to them).
Chronic tonsillitis.
Pharyngitis.
Allergic reactions.
Chronic rhinitis and many other diseases of the nasopharynx.

The process of formation of a cyst in the maxillary sinus is in most cases invisible to humans. Moreover, if it is small in size, then the patient may not be aware of its occurrence at all, learning about the presence of such a problem quite by accident when undergoing an examination for another disease.

However, there are situations when this formation begins to grow greatly, filling the entire space of the axillary cavity. This, in turn, causes a violation of the drainage functions of the sinuses, which is fraught with the occurrence of sinusitis and other health problems.

In general, it is worth saying that sinusitis and cysts are two pathologies that are closely related to each other. They both affect the maxillary sinuses and can provoke the development of each other.

Symptoms

A small cyst can remain in the maxillary sinus for a long time and not affect a person’s well-being in any way; numerous problems begin if the tumor reaches 10 centimeters or more. The most commonly observed symptoms are:

Chronic headaches, usually in the back of the head and temple. The pain intensifies during physical and emotional stress, as well as in autumn and spring;
Constant nasal congestion, without any signs of a cold;
Difficulty breathing, wheezing, shortness of breath during exercise;
Regular diseases of the nasopharynx - sinusitis, sinusitis, frontal sinusitis and others;
Unpleasant sensations when swallowing and closing the jaw.

Constant and incessant nasal discharge is a characteristic symptom of a maxillary sinus cyst. As a rule, the mucus has a characteristic yellowish or cloudy tint due to the purulent infiltrate released from the tumor cavity. With severe inflammation, the temperature increases and general weakness of the body is felt.

Possible complications

Regardless of whether a person has been diagnosed with a cyst of the right maxillary sinus or the left, there is always a risk of its inflammation and suppuration. Therefore, it is undesirable to delay treatment of this pathology, as serious health problems may arise.

Moreover, if the cyst of the maxillary sinus is of a true nature, then it can grow to a large size and burst, as a result of which all the pathological fluid will come out and inflammation of all nearby tissues will occur. And if there is pus inside the formation, then when the membrane ruptures, it can spread to the brain, causing the development of irreversible consequences in it.

In addition, if the left maxillary sinus cyst bursts, there is a high risk of sepsis and abscess, which can be fatal in a matter of hours.

In addition, the appearance of such formations in the sinuses near the nose leads to disruption of nasal breathing, as a result of which the body begins to experience oxygen deficiency, from which, first of all, the brain also suffers.

Important! When negative factors influence the body, malignancy of the cyst may occur!

Considering all these complications, young guys are not even accepted into the army with such a pathology, since it really poses a serious threat to life. Therefore, if you have the first symptoms of a maxillary sinus cyst, you should immediately consult a doctor and get treatment. Otherwise, avoiding serious health problems will be very problematic.

Causes

The location of the maxillary sinuses relative to other anatomical structures.

The main reason for the development of cysts is blockage of the ducts of the secretory glands that secrete mucus. When closing, the secretion stretches the walls of the duct and gradually fills with serous fluid.

A number of factors contribute to the appearance of such protrusions:

chronic inflammatory processes in the maxillary sinus (sinusitis):
heredity;
injuries;
anatomical abnormalities of the nasal bones and excretory ducts of the glands;
diseases of the teeth of the upper jaw and surrounding tissues.

It is known that the roots of the teeth of the upper jaw (mainly premolars and molars) can protrude into the bottom of the maxillary sinus or be separated from it by a thin bone septum. They are what lead to odontogenic cysts.

Clinical manifestations

When cysts form in the maxillary sinuses, symptoms may vary. Moreover, some signs of this pathology at first glance may seem completely unrelated to each other.

Regardless of where exactly the cyst appeared (in the right or left sinus), it can manifest itself with the following symptoms:

Soreness that occurs in the area of the eyes and bridge of the nose, since this is where the maxillary sinuses are located. The pain syndrome is constant and intensifies with head movements.
The secretion of viscous mucus, which contains impurities of pus. It should be noted that such mucus can be released not only from the nose, but also flow down the back wall of the throat, forming crusts on it, causing a sore throat.
Facial asymmetry. When the cyst grows to a large size, the upper and lower eyelids swell, and the eyeball becomes displaced. And the larger the tumor size, the stronger the asymmetry.

In cases where the neoplasm fills the entire cavity of the maxillary sinuses, this becomes the cause of blockage. As a result, this person begins to suffer from a headache, which even analgesics do not help get rid of. There may also be problems with nasal breathing, and there may be a feeling of fullness in the forehead and bridge of the nose.

But if the cyst of the right maxillary sinus is small and not prone to progressive growth (false), then it does not manifest itself at all. However, it cannot be ignored, since there are still risks of its degeneration into a malignant tumor.

Causes

There are two types of benign tumors:

radicular (formation of a cystic granuloma that develops and penetrates the maxillary sinus, filling it with pus or sulfur);
follicular (their formation is provoked by a disturbance in the development of dental follicles). The second type is rare.

All causes of the formation of cysts in the upper maxillary sinus can be divided into those associated and not associated with dental diseases.

True cystic formations often do not depend on dental diseases; the reasons for their appearance and development include:

blockage of the ducts of the glands that produce secretions. They are located on the mucous membrane of the maxillary sinus;
chronic diseases (sinusitis, rhinitis);
violation of the condition of the outlet of the maxillary sinus - anastomosis, which can be greatly expanded;
prolapse of the hard palate;
deviated nasal septum, abnormal position or shape of cartilage or bones;
deformation of the skull bones.

These reasons contribute to the formation of one or several cysts, which can be located on any wall of the maxillary sinus, but more often they form on the lower alveolar wall. Another dangerous factor is allergies. Prolonged presence of allergens in the maxillary sinuses provokes the development of tumors.

Ondogenic cysts are formed due to the pathology of one or more teeth. The causes of their appearance are considered to be diseases of the gums and teeth, infections of the oral cavity that cause inflammation.

In some cases, the cyst does not cause any inconvenience and resolves on its own. But most often its development leads to the filling of the maxillary sinus with pathological fluid. If this happens, treatment is necessary.

Diagnostics

The traditional method for diagnosing this pathology is x-ray examination. However, it is not very informative and can only confirm the presence of a cyst in the maxillary sinus. However, what type it is cannot be seen on the x-ray. And besides, it is also impossible to determine on an x-ray what exactly the formation is filled with.

Regardless of where the cyst was found according to the results of the X-ray examination, on the left or on the right, further diagnosis necessarily includes:

probing;
endoscopic examination of the sinuses;
CT.

To determine the nature of the contents of the cyst, they will definitely take a puncture, which is carried out using local anesthesia. This study is the most informative and allows us to determine not only the nature of the contents of the formation, but also the presence of cancer cells.

Treatment methods

If a person has been diagnosed with cysts in the maxillary sinuses, then treatment can be carried out either conservatively or surgically. Which particular method of therapy will be used is decided only by the attending physician after receiving all the results of the examination and establishing the cause of the appearance of the tumor in the sinus.

If the occurrence of a cyst in the left or right sinus was provoked by infectious or inflammatory diseases of the oral cavity, then first of all it is necessary to treat them. Once they are eliminated, the irritant will disappear and excessive mucus production by the sinus glands will stop.

In situations where the patient is very bothered by headaches, nasal congestion, swelling of the face, etc., the cyst in the maxillary sinus is removed. However, if this pathology is accompanied by an exacerbation of sinusitis, then antibacterial and anti-inflammatory therapy must be carried out before surgery.

And if the patient is not bothered by the maxillary cyst at all and it was discovered by chance during an X-ray examination, then treatment may not be required at all. But in these situations, many people make a big mistake - they believe that the doctor is not competent and begin to self-medicate, using unconventional methods of treatment. But you can’t do this!

Important! If the doctor said that in this case no treatment is required and you just need to observe the cyst, this does not mean that unconventional treatment methods can be used. This can only intensify pathological processes in the maxillary sinus, which will cause progressive growth of the tumor and the need for surgery.

Conservative treatment

Conservative methods of treating cysts in the axillary cavities are carried out only with the aim of eliminating the cause that provoked its occurrence. In other words, complete sanitation of the oral cavity and treatment of chronic diseases of the nasopharynx are carried out.

If the root cause is not eliminated, then even after surgical intervention the risks of relapse of the disease remain quite high. This is due to the fact that if the irritant also continues to exert its influence on the glands of the maxillary sinuses, cysts may form again. Conservative treatment alone cannot contribute to the resorption of such formations.

Modern diagnostic methods

Treatment of such diseases, as a rule, is radical, regardless of the size of the formation.

In most cases, three methods are used:

classical resection;
laser removal;
endoscopy.

The first two methods are highly effective, but their significant disadvantage is access. They are performed using open access, which is more traumatic for surrounding healthy tissue.

As a result, the patient’s recovery time is slightly increased. Endoscopic intervention does not injure the tissues of the nasal cavity as much and is safer.

Maxillary sinusotomy

Classic maxillary sinusotomy.

This is an operation in which the maxillary sinus is opened through an opening in the upper jaw. After opening, the mucous membrane is completely cleaned of pathological tissues using a special curette.

The operation is performed under anesthesia. Afterwards, the sinus cavity is drained, and the patient remains in the hospital for a week.

Microgaymorotomy differs from the classic one in that the operation is performed through the nose. As a result, the volume of intervention is less, and the patient’s recovery rate is increased.

Endoscopy

Scheme of endoscopic cyst removal.

This is the most modern and most gentle treatment method. Instruments are inserted into the sinus cavity through the anastomosis and the formation is removed under the control of an endoscope.

This method causes less trauma to soft tissue, which speeds up the patient’s recovery time. The operation is performed under local anesthesia.

There are several types of surgical intervention:

Puncture of the cystic cavity;
The intervention is endoscopic;
Denker's operation;
Operation CaldwellLuke.

During this operation, the maxillary sinuses are pierced using a special needle. But this operation provides only temporary relief. Removal is done through the nasal cavity. The contents are sucked out using a syringe. The cavity begins to shrink, but the walls remain.

Nasal congestion and headaches disappear, but only until the fluid fills again. Then they resume.

Using this method, you can perform a surgical, minimally invasive intervention. Incisions can be avoided through the use of an endoscopic device. This operation is carried out in the following way: an endoscopic tube is inserted into the anastomosis of the maxillary sinuses through the middle meatus. A special camera located on the endoscope allows you to monitor the progress of the surgical process and visually determine the anatomical state of the nasal passage and paranasal sinuses.

The advantages of this operation are:

Not accompanied by complications;
Affordable and efficient technique;
The walls of the maxillary sinuses are not damaged and further inflammation is impossible;
The surface after surgery remains without scars.

This operation is intended for maxillary formations. Through this operation, it is possible to prevent infection from entering and block the entrance hole of the odontogenic cyst.

The procedure for performing such an operation is as follows: it is performed exclusively using local anesthesia. An anesthetic is injected into the maxillary fold, located at the base of the oral cavity. After this, a small incision is made and access to the sinus is opened. The scale of the intervention also determines the size of the access hole.

The wound made during the operation is closed with biomaterial or heals on its own. For 3 days after the surgical intervention, the patient is under constant supervision of specialists, and at the end of this period, with a successful outcome, he is discharged from the hospital and is observed only on an outpatient basis.

This operation has several features:

There is no destruction of the canal that connects the maxillary maxillary sinuses and the middle nasal passage;
It is not always possible to remove a tumor, especially in cases where its size exceeds 1 cm;
The anterior wall of the maxillary sinus is injured, and this does not have a very good effect on the body. Infections can enter through this hole. But in a modified operation, it is envisaged to close the wound with biomaterial or a T-shaped flap.

Operation Danker

This type of surgical intervention differs from the previous one only in that the access point is the facial wall. The advantages of this operation:

formations can be removed in hard-to-reach places;
extensive field for operation.

This type of surgery is quite traumatic. But without its use, it is impossible to remove a cyst from the back wall of the maxillary sinuses in any other way.

If there are no symptoms, your doctor may recommend not starting treatment for the cyst. In this case, you can use traditional recipes or procedures to eliminate the cyst.

Aloe juice helps reduce tumor growth. It needs to be instilled into each nostril, 3-4 drops. At home, the juice of golden mustache leaves will also help to cope with cysts. In the morning and before going to bed at night, you need to instill 2 drops of the product into each nasal passage.
Cyclamen drops help well with cysts. You can prepare them yourself. To do this, take tubers of cyclamen forest, grate them and squeeze out the juice through cheesecloth. Instill 2 drops daily in the morning. Treatment is carried out for one week, after which a break is taken for 2 months. After this period, the drops are instilled again for one week.