A cyst in the nasal sinus is a pathological cavity filled with liquid contents.. It can be congenital and acquired, it can occur in both adults and children.. Clinical manifestations depend on the location of the neoplasm, type, size and presence of complications.. The most common cystic formations of the maxillary, or maxillary, paranasal sinuses. The main method of treating pathology is operative, according to the online publication for girls and women from 14 to 35 years old Pannochka. net Cysts develop as a result of prolonged inflammation of the mucous membrane of the nasal sinuses Localization of cysts Benign cystic neoplasms form in all paranasal paired sinuses:.

maxillary, located between the lower edge of the orbits and the alveolar process of the upper jaw;

frontal, localized in the scales of the frontal bone;

ethmoid, located between the eye sockets and the nasal cavity;

sphenoid, or main, divided by a septum into two halves, and located in the body of the sphenoid bone.

Of all the cysts of the sinuses, more than half are accounted for by cavitary formations of the maxillary sinuses..

Causes of the disease Cysts in the paranasal sinuses in the vast majority of cases are due to inflammatory processes of the mucous membranes lining their inner surface. Chronic diseases of both bacterial and allergic nature (sinusitis, frontal sinusitis, ethmoiditis, sphenoiditis) disrupt tissue regeneration and patency of the mucosal gland ducts, provoking the accumulation of secreted fluid.

Curvature of the nasal septum, hypoplasia of the nasal concha, anomalies of milk teeth contribute to the occurrence of pathological cavities. Congenital cysts in the nose are a consequence of intrauterine developmental defects.

Varieties of cysts in the sinus of the nose There are several main types of hollow formations of the paranasal sinuses.

Type of cyst.

Formation mechanism.

True.

Occurs due to impaired patency of the excretory ducts of the glands of the mucous membrane of the sinuses as a result of inflammatory edema, cicatricial or hyperplastic processes, necrosis. Continued production and accumulation of liquid secretions lead to a gradual stretching of the walls of the gland and the formation of a cavity lined from the inside with a columnar epithelium.. Typical localization - the lower or outer wall of the sinus.

False.

It is formed in the thickness of the mucous membrane, as a result it does not have an epithelial lining. Is a cyst-like or lymphangiectatic mass. May be single or multiple, found more often in children, in a large number of cases it is allergic in nature.

Odontogenic.

Occurs in the maxillary sinus, both right and left. In origin, the main role is played by the pathology of the roots and tissues of small or large molars.. There are two varieties: follicular and periradicular, or radicular. The basis of the first is an underdeveloped impacted tooth germ, called a follicle, or an inflamed milk tooth, the second is necrotic changes or an epithelial granuloma at the apex of the root of a carious tooth against the background of atrophy of the bone tissue of the upper jaw.

congenital.

Is the result of a congenital pathology of the upper jaw, sphenoid, frontal, ethmoid bones, ducts of the mucous glands, the glandular tissue itself or adjacent structures of the sinus cover.

Symptoms Pathology may be asymptomatic and be an incidental finding on x-ray of the nose, computed tomography or magnetic resonance imaging of the facial skull, performed during examination for another disease.

The nature of complaints is largely determined by the size, localization, duration of the cystic formation..

Localization.

Clinical signs.

Maxillary sinus.

With a significant diameter of the formation and prolonged pressure on the wall of the sinus, the following are possible: displacement of the eyeball on the side of the lesion forward and upward, up to the orbit; limitation of mobility downwards; crunch, like parchment, on palpation of the lower wall of the orbit; unilateral lacrimation due to impaired lacrimation; bulge in the inner corner of the eye; intermittent diplopia (double vision).

Frontal.

Headache of a persistent nature, displacement of the eyeball forward and / or downward, sometimes protrusion of the lower wall of the sinus, felt on palpation. In severe cases, narrowing of the palpebral fissure is possible..

wedge-shaped.

Pain in the eye, unilateral or bilateral displacement of the eyeball forward, decreased visual acuity due to retrobulbar neuritis or primary atrophy of the optic nerve, paralysis of the eye muscles due to damage to the motor nerves, doubling, sometimes swelling of the eyelids, loss of sensitivity of the upper eyelid, cornea,.

lattice.

Difficulty in nasal breathing, decreased sense of smell, narrowing of the lumen of the nasal passages. Perhaps the accumulation of secretions in the nasal passages, the formation of polyps, as in the chronic course of sinusitis.

The appearance of weakness, fever, increased pain are possible with the development of complications. One of the most dangerous and frequent is the suppuration of the cyst, due to which the mucous, serous, purulent contents fill the sinus cavity and stretch it..

Over time, overgrown cystic structures can lead to facial asymmetry, lowering of the hard palate, and fistula formation.. Large formations can provoke a decrease in the thickness and destruction of the walls of the accessory sinuses, displace neighboring organs.

Diagnosis When making a diagnosis, a comprehensive analysis of the patient's complaints and examination are supplemented by:.

radiography of the paranasal sinuses in two projections;

CT scan;

Magnetic resonance imaging;

diagnostic puncture;

cytological, biochemical, microbiological examination of punctate.

On X-ray photos, the cyst looks like a rounded shadow against the background of an air-filled sinus cavity.. It is possible to conduct a study with contrast, revealing a formation in the form of a rounded filling defect.

Therapeutic tacticsTreatment of pathology - surgical. Removal of a cyst in the nasal sinus is performed in the presence of complaints and a high likelihood of complications. Doctors use two main options for surgery.

Surgical intervention method.

Technical features.

Classical.

Access to the outer wall of the sinus is carried out through an incision in the mucous membrane under the upper lip, the cystic formation is removed through the formed hole.

Endoscopic.

Allows removal of cystic formation without incisions: the optical system and endoscopic instruments are inserted through the nasal cavity and natural openings of the paranasal sinuses.

Endoscopic technique allows:.

reduce operation time;

reduce tissue trauma;

minimize the chance of complications;

shorten hospital stay.

Treatment of cavitary formations of the paranasal sinuses is carried out by otorhinolaryngologists. Removal of odontogenic cysts is carried out in conjunction with dentists to minimize complications.

If during the diagnosis a cyst of the nasal sinuses of a significant size is found that causes complaints, the neoplasm is removed. The existence of a cystic cavity in the paranasal sinus can make it difficult to drain and provoke the development of a chronic inflammatory process, therefore, painkillers, antihistamines, and antibacterial drugs are often included in the complex of therapeutic measures.. This is done both at the stage of preparation for surgery and in the postoperative period.. The selection of antibiotics is carried out in accordance with the results of a microbiological study of secretions or the contents of the cavity obtained by puncture.

Prognosis and preventive measures In the presence of cystic neoplasms of the paranasal sinuses, the prognosis for both the life and health of patients is favorable. The modern level of diagnostics and timely complex treatment allow achieving full recovery.. The occurrence of relapses is not characteristic of this pathology..

General preventive measures include:.

early diagnosis of cysts of the paranasal sinuses;

detection and treatment of diseases of the nasal cavity and paranasal sinuses of an inflammatory and allergic nature;

sanitation of the oral cavity;

correction of anomalies in the development of the upper jaw and nasopharynx.

The fulfillment of these conditions allows to reduce the possibility of the formation of a pathological cavity in the sinus or to prevent the development of complications if it is present..

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