No4(4) 2021
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DOI 10.37219/2528-8253-2021-4-54 |
Shkorbotun YaV
Maxillary sinus cyst as a risk factor for osteomeatal complex block |
Shkorbotun Yaroslav V
State Institution of Science «Research and Practical Center of Preventive
and Clinical Medicine»
State Administration Department
Department of miniinvasive surgery, Kyiv, Ukraine
National University of Helthcare named after P. L. Shupyk, Department of
Otolaryngology, Kyiv, Ukraine
Candidate of Medical Sciences, Associate Professor
Email: lorkiev@ukr.net
Orchid ID: http://orcid.org/0000-0002-3103-7194 |
Abstract
Introduction: Cysts of the maxillary sinuses are found in about 10%
of the population. There is a necessity to clarify indications for cyst
removal taking into account its size.
The purpose of the study to clarify the indications for surgical
treatment of maxillary sinus cysts as a risk factor for sinus drainage
disorders in the development of maxillary sinusitis.
Methods and materials: 57 people (92 sinuses) were examined. There
were 20 patients (40 sinuses) with acute rhinosinusitis, 22 patients (22
sinuses) with post-augmentation sinusitis, and 15 (30 sinuses) almost
healthy individuals among them. Prediction of the cyst size, which can lead
to blockage of the maxillary sinus ostium, was performed by direct
measurement on coronary sections at the ostiomeatal complex level distance
from the surface of the mucoperiosteum in the area of the alveolar recessus
to the lower surface of the mucosal surface in the area of the ostium. The
obtained data were verified by calculation method taking into account the
height of the sinus at the level of the osteomeatal complex, the magnitude
of possible mucoperiosteum edema in the alveolar recessus and ostium in
acute rhinosinusitis and post-augmentation sinusitis, as well as the
magnitude of mucoperiosteum elevation due to sinus lift.
Results: It was found that the vertical size of the cyst, which can
potentially lead to blockage of the maxillary sinus ostium in acute
rhinosinusitis is 21.2±0.8 mm, 14.7±1.1 mm in sinusitis after augmentation
of the maxilla, and 28.5±0.7 mm in practically healthy individuals. The
calculated values are 18.5 mm, 14.0 mm and 24.5 mm, respectively. In case of
acute rhinosinusitis, the distance from the apex of the cyst to the surface
of the mucous membrane of the ostiomeatal complex area may decrease by 12.8
mm, and in sinusitis after sinus lift it may decrease by 20.4 mm.
Conclusions: To assess the potential of the ostiomeatal complex block
by a cyst located in the alveolar recessus in acute rhinosinusitis, its
vertical size is really important according to coronary sections of at the
ostiomeatal complex level corresponding to the location of 5-6 teeth of the
upper jaw. The indication for removal of the cyst of the alveolar recessus
of the maxillary sinus, as a factor that may worsen the course of acute
rhinosinusitis due to the anastomosis block, is its size exceeding 20 mm,
and 15 mm for patients who plan to sinus lift. |
Keywords
maxillary sinus cyst, ostium block, sinusitis, subantral bone augmentation,
sinus lift, indications for surgical treatment. |
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