Abstract:ObjectiveTo investigate the clinical effect of the treatment of giant maxillary bone cysts with intranasal fenestration.MethodsFive patients with maxillary bone cyst were selected and diagnosed by preoperative puncture through nasal sinus CT and MRI. All giant maxillary bone cysts of 5 cases were larger than 3.5 cm. All patients were treated with intranasal fenestration under nasal endoscope. According to the location of maxillary cysts in nasal cavity and sinus, the giant maxillary cysts were treated with the nasal floor fenestration and the inferior nasal meatus fenestration respectively, or the anterior lacrimal crypt fenestration if necessary.The walls of the cysts were removed surgically. Two patients of them with limited cysts were chosen simple fenestration of nasal base because cyst was mainly close to nasal base. Two patients were chosen maxillary sinus fenestration via the lower nasal passage because their cysts were involved in the maxillary sinus.One patient visited the doctor before surgery for toothache, who was recommended postoperative extraction of the affected tooth. One patient was performed the fenestration of inferior nasal meatus combined with fenestration of anterior lacrimal recess due to the special location of maxillary cyst and its proximity to the anterior wall of maxillary sinus. Contrapuntal suture incision, and postoperative iodoform gauze compression and saline irrigation were performed to clear the operative cavity and maintain an unobstructed drainage.ResultsThere were no serious complications in all of the five patients. The cystic epithelialization occurred about 3 months after operation. The window drainage was unobtrusive during the followup for half a year were recorded. No recurrence of all cases was observed.ConclusionsIntranasal fenestration is a simple and common surgical procedure, which has the advantages of less bleeding, less trauma and low recurrence rate. Maintaining an unobstructed drainage is the key to reduce the recurrence of maxillary bone cyst.
