Management of Radicular Cysts Extending into the Maxillary Sinus
XXIII. World Congress of Otorhinolaryngology, İstanbul, Türkiye, 9 - 13 Eylül 2026, ss.1-2, (Özet Bildiri)
- Yayın Türü: Bildiri / Özet Bildiri
- Basıldığı Şehir: İstanbul
- Basıldığı Ülke: Türkiye
- Sayfa Sayıları: ss.1-2
- Kütahya Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background & Aim
Radicular cyst are inflamatory odontogenic cysts, and they
are the most common cystic lesions of the jaws. They typically arise at the
apex of a non-vital tooth following pulpal necrosis. Most of them are
asymptomatic and remain small in size; however, in rare cases, they may enlarge
significantly and extend into adjacent structures. In this study, we aimed to
present our surgical experience in the management of radicular cysts with
sinonasal extension using a combination of endodontic, transoral, and
endoscopic transnasal approaches, and to emphasize the importance of a
multidisciplinary strategy in such cases.
Material & Methods
A total of 7 patients who underwent multidisciplinary
surgery for extensive odontogenic radicular cysts involving the maxillary sinus
between April 2025 and April 2026 were retrospectively reviewed. The surgiries
were performed through a collaborative approach between the Otorhinolaryngology
and Oral & Maxillofacial Surgery departments. Demographic characteristics,
clinical findings, surgical techniques, histopathological outcomes, and
postoperative follow-up data were analyzed.
Results
The study included 7 patients with a mean age of 46 years.
Four patients were male and 3 were female. In all cases, the radicular cysts
originated from the dental apex and expanded into the maxillary sinus. A
sulcular incision was preferred in 5 patients (71.4%), while a sublabial
incision was performed in 2 patients (28.6%). Piezosurgery was used to remove
the bone covering the cyst. Following apical resection of the involved teeth,
retrograde root-end filling was performed using Mineral Trioxide Aggregate. In
six cases (85.7%), transnasal endoscopic maxillary antrostomy was performed
because of the communication between the cyst cavity and the sinus. One patient
(14.3%) had previously undergone endoscopic sinus surgery. In 2 cases with
extensive bone defects, a buccal fat pad flap was utilized to support the
mucosa and prevent defective healing. During the follow-up period (2–12
months), no clinical or radiological recurrence was observed.
Conclusions
Extensive odontogenic cysts involving the maxillary sinus
may require a combined surgical approach. Careful endodontic preparation,
intraoral enucleation, endoscopic sinus control, and vascularized soft tissue
support can provide safe treatment while helping to preserve the teeth and
adjacent sinonasal structures. Although several case reports on radicular cysts
have been reported in the literature, comprehensive case series focusing
particularly on large radicular cysts extending into the maxillary sinus appear
to be limited. This study presents a relatively large case series demonstrating
a multidisciplinary approach in the management of extensive radicular cysts
associated with the maxillary sinus.