Cyst In The Sinus: Symptoms, Treatment, Consequences

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2024-01-15 19:51

Cyst in the sinus

The content of the article:

Localization of cysts
Causes of the disease
Varieties of cysts in the sinus
Symptoms
Diagnostics
Therapeutic tactics
Forecast and preventive measures
Video

A cyst in the sinus is a pathological cavity filled with liquid contents. It can be congenital and acquired, it can occur in both an adult and a child. Clinical manifestations depend on the location of the neoplasm, the 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 operational.

Cysts develop as a result of prolonged inflammation of the sinus mucosa

Localization of cysts

Benign cystic neoplasms are formed 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;
lattice, located between the eye sockets and the nasal cavity;
wedge-shaped, 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 the cavity formations of the maxillary sinuses.

Causes of the disease

Cysts in the paranasal sinuses in the overwhelming majority of cases are caused by 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 the permeability of the ducts of the mucous glands, provoking the accumulation of secreted fluid.

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

Varieties of cysts in the sinus

There are several main types of hollow formations of the accessory sinuses of the nose.

Cyst type	Formation mechanism
True	It occurs due to a violation of the 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. Ongoing 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 cylindrical epithelium. Typical localization is the inferior or outer sinus wall.
False	It is formed in the thickness of the mucous membrane, as a result of which it does not have an epithelial lining. It is a cyst-like or lymphangiectatic formation. It can be single or multiple, it is found more often in children, in a large number of cases it is of an allergic nature.
Odontogenic	It occurs in the maxillary sinus, both right and left. In the origin, the main role is played by the pathology of the roots and tissues of small or large molars. There are two types: follicular and peri-root, 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 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	It 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 the adjacent structures of the lining of the sinuses.

Symptoms

Pathology can be asymptomatic and be an accidental finding on nasal X-ray, computed tomography or magnetic resonance imaging of the facial skull, carried out during examination for another disease.

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

Localization	Clinical signs
Maxillary sinus	With a significant diameter of education 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; restriction of mobility downward; crunch, like a parchment, on palpation of the lower wall of the orbit; unilateral lacrimation due to impaired lacrimation; bulging in the area of the inner corner of the eye; fickle diplopia (double vision).
Frontal	Stubborn headache, 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, one- or two-sided displacement of the eyeball forward, decreased visual acuity due to retrobulbar neuritis or primary atrophy of the optic nerve, possible paralysis of the eye muscles due to damage to motor nerves, double vision, sometimes swelling of the eyelids, loss of sensitivity of the upper eyelid, cornea, parts of the forehead.
Lattice	Difficulty nasal breathing, decreased sense of smell, narrowing of the lumen of the nasal passages. The accumulation of secretions in the nasal passages, the formation of polyps is possible, 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 cyst suppuration, as a result of which the mucous, serous, purulent contents fills the sinus cavity and stretches it.

Diagnostics

When making a diagnosis, a comprehensive analysis of patient complaints and examination are complemented 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 tactics

Pathology treatment is surgical. Removal of a cyst in the nasal sinus is carried out in the presence of complaints and a high likelihood of complications. Doctors use two main types of surgery.

Surgical method	Technical features
Classical	Access to the outer wall of the sinus is carried out through an incision of the mucous membrane under the upper lip, the cystic formation is removed through the formed opening.
Endoscopic	Allows you to remove cystic formation without incisions: the optical system and endoscopic instruments are inserted through the nasal cavity and natural openings of the paranasal sinuses.

The endoscopic technique allows:

reduce the operation time;
reduce tissue trauma;
minimize the likelihood of complications;
reduce the length of hospital stay.

Otorhinolaryngologists are engaged in the treatment of cavity formations of the accessory sinuses. Removal of odontogenic cysts is performed in conjunction with dentists to minimize complications.

If the diagnosis reveals a significant sinus cyst causing complaints, the neoplasm is removed

The existence of a cystic cavity in the paranasal sinus can impede its drainage and provoke the development of a chronic inflammatory process, therefore, pain relievers, antihistamines, 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 examination of secretions or cavity contents obtained during puncture.

Forecast and preventive measures

In the presence of cystic neoplasms of the accessory sinuses of the nose, the prognosis for both life and health of patients is favorable. The modern level of diagnostics and timely complex treatment allow achieving complete recovery. The occurrence of relapses is not typical for this pathology.

General preventive measures include:

early diagnosis of cysts of the accessory sinuses of the nose;
identification 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.

Fulfillment of these conditions makes it possible to reduce the possibility of the formation of a pathological cavity in the sinus or to prevent the development of complications in its presence.