Bilateral postoperative maxillary cysts after orthognathic surgery: A case report

Maxillary surgical ciliated cysts following advancement Le Fort I osteotomy with concomitant autogenous bone grafting: a simple coincidence or a cause-effect relationship?

Surgical ciliated cysts (SCCs) are rare benign lesions that have been described after radical maxillary sinus surgery such as a Caldwell-Luc procedure for chronic sinusitis. They usually occur several years following surgery, and they typically present as an evolving swelling in the maxillary sulcus and cheek area. The pathogenetic mechanism is related to the entrapment of respiratory epithelium from the paranasal sinuses and/or the nose within the wound created by the surgical procedures. Radiologically, SCCs manifest as a well-demarcated, unilocular or multilocular radiolucency and histologically are lined by respiratory epithelium. Enucleation remains the treatment of choice. Since the 1990s, cases of SCCs have also been described following orthognathic surgery and developing not only within the maxilla but also surprisingly within the mandible. We report here three unique cases of patients with postoperative maxillary cysts following Le Fort I advancement osteotomy with concomitant inter-positional gap autogenous bone grafting.

Reconstruction of Large Orbital Floor Defect Caused by Maxillary Sinus Mucocele

Maxillary sinus mucocele can occur due to many medical factors such as chronic infection, allergic sinonasal disease, trauma, and previous surgery. However, it occurs mainly after Caldwell-Luc operation, usually more than 10 years after surgery. There are a few cases of maxillary sinus mucocele with ocular symptoms. Also, a case causing ocular symptoms because of invasion to the orbital floor is rare. Therefore, we report a case of a 55-year-old male patient who underwent Caldwell-Luc operation about 30 years ago. Then, symptoms such as exophthalmos, diplopia, and visual disturbance developed suddenly 3 months prior to admission. Computed tomography showed a cyst invading the orbital floor which resulted in eyeball deviation. The orbital floor defect measured approximately 2.5×3.3 cm. Maxillary sinus mucocele was removed through an endoscopic approach. After this, we reconstructed the orbital floor through a subciliary incision. Observation was carried out after three years, and ocular symptoms such as diplopia and exophthalmos did not recur.

Transnasal endoscopic removal of bilateral postoperative maxillary cysts after aesthetic orthognathic ssurgery: Differences from that of Caldwell-Luc operations

Postoperative maxillary cysts (PMCs) after orthognathic surgery are a rare disease condition. In this study, we reported first case of bilateral PMCs after cosmetic orthognathic surgery which was treated via the intranasal endoscopic approach. In addition, we compared the characteristics of PMCs after aesthetic orthognathic surgery with those of PMCs after Caldwell-Luc operation. We expect that this case will be helpful to surgeons who encounter similar cases.

Haemophilic pseudotumour in two parts of the maxilla: case report

Haemophilic pseudotumour is a rare disease that occurs most often in femur, tibia, ilium or pelvic bone of a patient with haemophilia. Thus far, there have been only 31 reported cases in jaw bones and paranasal sinuses. Among them, the mandible is a more common site than the maxilla or paranasal sinuses. Here, we report a case of haemophilic pseudotumour in two parts of the maxilla. Contrast-enhanced CT showed an expansive and thinly corticated lesion with fluid attenuation at the left anterior maxilla which seemed like a post-operative maxillary cyst, ameloblastoma or odontogenic cyst. In addition, the thickened left palatal process of the maxilla seemed like fibrous dysplasia or intraosseous vascular malformation. Since haemophilic pseudotumour is not pathognomonic in radiological findings, when a patient who suffered from haemophilia or had taken anticoagulating agents has jaw lesion, haemophilic pseudotumour should be included in a differential diagnosis.