Selection of the optimal approach for the excision of the odontogenic cyst of the maxillary sinus

The incidence of odontogenic cysts of the maxillary sinus varies from 0.7% in asymptomatic patients to 2.8% in patients with clinical signs of maxillary sinusitis. Intranasal and transoral approaches are used during the excision of odontogenic cysts. Aim of the study. Determining the main selection criteria for the optimal approach for the excision of the odontogenic cyst of the maxillary sinus. Patients and methods. 54 patients were included into the study; they were divided into groups based on the presence or absence of the natural junction obstruction and the odontogenic cyst features according to computed tomography data. During the study, intranasal, transoral approaches, or their combination was used. The efficacy of surgical interventions used and the local status of patients during the first week of the postoperative period were accounted for. Data from histological studies of intraoperative biopsy specimens were also analyzed. 6 months later, the follow-up examination and cone-beam computed tomography of paranasal sinuses were conducted. Results. Complete recovery was confirmed in 51 patients out of 54 based on follow-up cone beam tomography scans. 2 patients managed with the intranasal approach had an incomplete excision of the ossified cyst wall. Sinusitis relapse with significant osteitis was observed in one case after the combined approach for the ossified cyst. Conclusion. Main selection criteria for the approach in odontogenic cysts of the maxillary sinus include the condition of the natural junction, as well as features of the odontogenic cyst sac structure. © 2023, Media Sphera Publishing Group. All rights reserved.