The maxillary sinus cyst is formed as a result of blockage of the excretory duct of the acinous gland of the mucosa. This process can be triggered by necrosis, hypersecretion or exudation of the glands, caused, in turn, by inflammation in the mucosa. At the same time, necrotic masses stretch the excretory ducts and the end sections of the glands. In some cases, a cyst of the maxillary sinus is formed due to constriction of the mucosa by proliferating connective tissue. In this case, the lumen of the gland is filled with dense contents and its extension.
A maxillary sinus cyst, having a dental origin, can be radicular or follicular. The formation of a radicular (near-root) occurs due to necrosis from granulomas (epithelial) in the root apex of a carious tooth. The cyst of the maxillary sinus, due to atrophy in the surrounding bone, grows into the jaw substance, shifts the bottom of the maxillary sinus and penetrates into it. The follicular grows from the dental follicle rather slowly. Such a cyst is more often detected between the ages of ten and fourteen. The formation occurs due to a violation in the development of the rudiment of the retined tooth, as well as due to inflammation in the milk tooth.
Cyst of the maxillary sinus. Symptoms
The main manifestation of these conditions is a dull headache. As a rule, it occurs on the side of the cyst in the frontal region.
The clinical manifestations of the conditions include tension and heaviness in the cheek area, pain of a neuralgic nature that occurs due to pressure on the ends of the facial nerve. As symptoms, lacrimation should be noted on the side of the formed cyst, protrusion of the bottom of the nasal cavity, swelling in the area of the anterior wall in the sinus, and carious teeth are noted. On palpation, a characteristic sound is noted - "parchment crunch" (a sign of Dupuytren).
Particularly severe cases are accompanied by severe facial asymmetry. There is some omission of the hard palate, the formation of fistulas. It should be noted that these manifestations are not observed with the formation of cysts of the mucous membranes of the maxillary sinuses.
The cystic cavity is lined with epithelium. The outer wall of the cavity is formed by a thinned plate of the jaw bone: inside the cavity, together with the liquid contents, one or more dental rudiments or formed teeth are revealed.
The cyst can be purulent, cholesteatomic. The liquid contained in the cavity may have a yellow color with cholesterol crystals. According to the results of some studies, a cyst of the right maxillary sinus is formed more often than the left.
Diagnosis is made if there is a rounded shadow on the radiograph against a light background. In this case, the sinus is the light background , and the cyst is the shadow. An x-ray can be used simple or with a contrast agent.
Cyst formation occurs within approximately two months. Sensitization of the mucosa provokes the accumulation of mediating substances (acetylcholine, histamine, serotonin). As a result of this, violations in the permeability of capillary walls subsequently occur. Penetration of tissue fluid from blood vessels causes internal edema of the mucosa.
In this case, patients experience difficulties with nasal breathing, which are expressed in the alternate laying of one or the second nasal half, a significant decrease in smell. The mucous membrane of the shells in this case acquires a whitish-cyanotic hue. Common manifestations should include, in addition to headache, anorexia, decreased memory, irritability, fatigue.
Cysts are treated promptly. A radical operation or frontotomy is used.