- What triggers / Causes of Cysts in the paranasal sinus
- Pathogenesis (what is happening) during the Cysts in the paranasal sinus
- The symptoms of Cysts in the paranasal sinus
- Diagnosis of Cysts of the paranasal sinuses
- Treatment of Cysts of the paranasal sinuses
- Which doctors should be consulted if You have a Cyst of the paranasal sinuses
What is a Cyst of the paranasal sinuses -
What triggers / Causes of Cysts in the paranasal sinuses:
True cysts are formed when the plugging of ducts Acinonyx glands of the mucous membranes of the sinuses as a result of necrosis, exudation and hypersecretion of the glands caused by inflammation of the mucous membranes. Is stretched excretory ducts and konjevic departments glands nekrotizirovannye masses. In some cases the formation of cysts is preceded by constriction of the mucous glands enlarged connective tissue. The lumen of the gland is gradually filled with dense contents and stretched.
Cysts of the maxillary sinuses of dental origin (odontogenic) may be radicular and follicular. Radicular (root-planing) a cyst formed as a result of necrosis of epithelial granulomas of the root apex of a carious tooth, grows in the substance of the jaw as a result of atrophy of the surrounding bone. Odontogenic cyst growth pushes the bottom of the maxillary sinus and gradually penetrates into the sinus.
Follicular cysts occur more frequently in the aged 10-14 years, grow very slowly from the dental follicle due to abnormalities in the development of impacted tooth Bud or as a result of inflammation of a milk tooth.
Pathogenesis (what is happening) during Cyst of the paranasal sinuses:
True (retention) cysts. False (lymphangiectasia or testopodobnymi education). Dental (odontogenic). Cysts associated with congenital malformations.
The symptoms of Cysts of the paranasal sinuses:
The main complaint of patients - occasional dull headache in the frontal region on the side of the cyst. Clinical symptoms of large dental cysts: heaviness and tension in the region of the cheek, headache, neuralgic pain resulting from pressure on the end of the trigeminal nerve, tearing on the side of the cyst, the protrusion of the bottom of the nose ("gebarowski cushion"), swelling in the anterior wall of the maxillary sinuses, carious teeth, a characteristic "crunch parchment" on palpation (a symptom of Dupuytren's). In advanced cases, there is facial asymmetry as a result of protrusion of the front wall of the maxillary sinus. The hard palate is somewhat lowered, formed fistula. Listed the characteristics of dental cysts do not occur in cysts of the mucous membrane of the maxillary sinus.
Cyst cavity lined by epithelium, the outer wall is formed by thinning of the bone plate of the jaw: in the cavity, except the liquid contents, locate one or more teeth formed or their rudiments.
Cysts may be serous, purulent and cholesteatoma contain yellow liquid with crystals of cholesterol.
Diagnosis of Cysts of the paranasal sinuses:
Diagnosis of cysts of the paranasal sinuses based on the following criteria: availability on radiographs (plain or with contrast) rounded shadows on the lighter background of the sinus-
Receive at the puncture or the sensing of the maxillary sinus cystic fluid (dark yellow with retention cysts or light yellow when lymphangiectasia). Cystic fluid contains albumin, cholesterol, fat. iron oxide, mucin, alkaline albuminates. From polypoid fluid differs rapidly advancing its crystallization after discharge from the maxillary sinus.
Differential diagnosis. The most difficult differentiation of retention and lymphangiectasia cysts on clinical grounds. Only histological examination to determine the nature of the cyst. Retention cyst - the most common true cyst. Usually located on the bottom wall of the maxillary sinus is lined on the inside cylindrical epithelium, clearly detected on the radiograph. Often asymptomatic, discovered by chance and gives the expressed symptoms upon reaching considerable size.
Lymphangiectasia cyst is defined as a false cyst or testopodobnaja education, has no epithelial lining, is formed in the thickness of the mucosa as a result of hyperergic inflammation on the background of vasomotor and allergic processes.
Can be multiple and can be positioned on any wall of the sinus.
For the formation of cysts quite 2 months. As a result of sensitization of the mucous membrane of the sinus it accumulate mediator substances such as histamine, acetylcholine, serotonin a subsequent breach of the permeability of capillary walls - the transition of fluid from the vessels into the tissue leads to the formation of internal mucosal edema. In children the most frequently observed this kind of cysts (up to 90).
Clinical manifestations: nasal obstruction, manifested in successive laying the two halves of the nose, decreased sense of smell, whitish-cyanotic color of the mucosa of turbinates, General symptoms (headache, fatigue, irritability, loss of memory, anorexia).
Lymphangiectasia cyst of frontal sinus show similar symptoms, more often localized on the medial or the bottom wall of the frontal sinus, often spontaneously emptied.
Treatment of Cysts of the paranasal sinuses:
Cyst removed by radical surgery of the maxillary sinus or frontotomia. In rare cases of maxillary sinus cyst removed endonasally with a sharp spoon (cystotomy) or by optical microsurgery. Surgery of the frontal sinus is shown only in case of large size of the cyst and closure of the fronto-nasal canal.