Right Maxillary Sinus Retention Cyst That Draining Into The Nasal Cavity

Understanding Maxillary Sinus Retention Cysts: Causes, Symptoms, and Treatment

Endoscopic evacuation of the retention cyst located in the right maxillary sinus, with the inner wall of the sinus pushed into the nose. The patient had complaints such as fullness, pain and pressure feeling due to the right chronic maxillary sinusitis.

Complaints of patient are disappeared after the endoscopically evacuation maxillary sinus contents. Maxillary sinus retention cysts are usually asymptomatic and treatment is not always necessary.

Retention cysts and solitary polyps are often asymptomatic as incidental findings in the paranasal sinuses and are considered complications of inflammatory sinusitis.

Maxillary sinus retention cysts, although relatively common, are often misunderstood and overlooked. These cysts can lead to a variety of uncomfortable symptoms and can be mistaken for other sinus-related conditions. In this article, we will explore what maxillary sinus retention cysts are, their causes, symptoms, diagnosis, and treatment options to help individuals gain a better understanding of this condition and seek appropriate medical care when needed.

What Are Maxillary Sinus Retention Cysts?

Maxillary sinus retention cysts, also known as maxillary sinus mucous retention cysts, are benign growths or cystic formations that develop within the maxillary sinus, which is one of the four pairs of sinuses located within the human skull. These sinuses are situated in the cheek area, and maxillary sinus retention cysts occur when there is an obstruction or blockage of the sinus's drainage pathway. This blockage can be attributed to various factors, leading to the accumulation of mucus within the sinus, which ultimately results in the formation of a cyst.

Causes of Maxillary Sinus Retention Cysts

Several factors can contribute to the development of maxillary sinus retention cysts:

Infection: Sinus infections, such as sinusitis, can lead to inflammation and swelling of the sinus tissues. Inflammation can disrupt the normal flow of mucus and create blockages, leading to cyst formation.

Allergies: Chronic allergies can cause inflammation and swelling in the sinus passages, increasing the risk of cyst formation.

Polyps: Nasal polyps are growths that can block the sinus passages and contribute to cyst development.

Trauma: Physical injury to the face or head can cause damage to the maxillary sinus and disrupt its normal drainage, potentially leading to cysts.

Congenital abnormalities: Some individuals may be born with structural abnormalities that make them more prone to developing maxillary sinus retention cysts.

Symptoms of Maxillary Sinus Retention Cysts

The symptoms of maxillary sinus retention cysts can vary in intensity and may mimic those of other sinus-related conditions. Common symptoms include:

Facial pain or pressure: Many individuals with maxillary sinus retention cysts experience pain or pressure in the cheek area. This discomfort can be persistent and worsen over time.

Headache: The buildup of mucus and pressure within the sinus can lead to headaches, particularly around the eyes and forehead.

Nasal congestion: The cyst can obstruct the natural drainage pathway of the maxillary sinus, causing nasal congestion and difficulty breathing through the affected nostril.

Postnasal drip: Excess mucus produced within the cyst may result in postnasal drip, which can lead to a sore throat and persistent cough.

Reduced sense of smell: Some individuals with maxillary sinus retention cysts report a diminished sense of smell, as the cyst may impede the flow of air through the sinus.

Bad breath: The accumulation of mucus can create an environment where bacteria thrive, leading to bad breath.

Mucous retention cysts are more common than serous retention cysts. Serous retention cysts are caused by the accumulation of fluid in the submucosal layer, while mucous retention cysts are caused by blockage of the seromucous glands. Retention cysts are common in the maxillary sinuses and have been detected in 9-35% of radiological studies. Retention cysts and solitary polyps appear flat on CT and MRI as outwardly convex soft tissue masses. MR signal intensities of cysts and polyps depend on their protein and water content.

Diagnosing Maxillary Sinus Retention Cysts

If you are experiencing any of the above symptoms, it is important to seek medical evaluation. A healthcare professional, often an ear, nose, and throat specialist (otolaryngologist), can diagnose maxillary sinus retention cysts through various means:

Medical history: Your doctor will ask about your symptoms and medical history to understand your condition better.

Physical examination: A physical examination of the face and nasal passages can reveal signs of tenderness, swelling, or other abnormalities.

Imaging: Imaging tests like a sinus CT scan or MRI can provide a detailed view of the sinus and help confirm the presence of a cyst. These scans can also rule out other potential causes of your symptoms.

Nasal endoscopy: In some cases, a flexible tube with a camera (endoscope) may be inserted into the nasal passages to examine the sinus more closely.

Treatment Options for Maxillary Sinus Retention Cysts

The treatment approach for maxillary sinus retention cysts depends on the severity of symptoms and the impact of the cyst on a patient's quality of life. Treatment options may include:

Observation: If the cyst is small and not causing significant discomfort, a "watch and wait" approach may be recommended. Regular monitoring by a healthcare professional is essential to assess any changes in the cyst.

Medications: In cases where the cyst is associated with inflammation or infection, medications like antibiotics and corticosteroids may be prescribed to manage symptoms and reduce inflammation.

Nasal irrigation: Rinsing the nasal passages with a saline solution can help alleviate congestion and reduce mucus buildup.

Surgery: If the cyst is large, causing persistent symptoms, or if other treatments are ineffective, surgical intervention may be necessary. The surgical procedure, called endoscopic sinus surgery, aims to remove the cyst and correct any underlying structural issues that contribute to cyst formation.

Balloon sinuplasty: This minimally invasive procedure involves the use of a small balloon to open and reshape the sinus passages, improving drainage and reducing the risk of cyst recurrence.

Polyp removal: If nasal polyps are contributing to the cyst's formation, they may need to be surgically removed to prevent recurrence.

Maxillary sinus retention cysts, while not typically life-threatening, can lead to significant discomfort and a reduced quality of life. Understanding the causes, symptoms, diagnosis, and treatment options for these cysts is crucial for individuals experiencing sinus-related symptoms. If you suspect you may have a maxillary sinus retention cyst or are experiencing persistent sinus issues, seek medical attention promptly to receive an accurate diagnosis and appropriate treatment. With the right approach, many individuals can find relief from their symptoms and improve their overall well-being.

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Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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