Cysts of the nose and paranasal

sinuses

Dr.Tawfik Elkholy
Assistant prof. of ENT&
laser surgery

H&N-skull base surgery

 Cysts of the nose and paranasal sinuses

1-Congenital cysts:
Dermoid cyst:
2-Odontogenic cysts. (Cysts of dental origin).
A- Dentigerous cysts.
B - Dental cysts:
3-Non odontogenic developmental cysts:
A-Nasopalatine cyst (incisive canal):
B-Nasolabial (nasoalveolar cyst):
4- Cysts arise from mucous membrane of the paranasal sinuses:
mucocele and Pyocele.
 1-congenital cysts.
Dermoid cyst:

• It occurs due to entrapping of some

ectodermal cells in the subcutaneous
tissue during development.

• it occurs in the midline at the nasal bridge.

• It is hemispherical or oval and firm with a

blackish small depressed spot at the center
(punctum).

• It is liable for recurrent infection.

• it is treated by surgical excision.

 2- Cysts of dental origin(odontogenic cysts).
A - Dentigerous cysts.

• Cyst formed in relation to an un-erupted

tooth in children or young age.

• It is due to cystic degeneration of the crown

of an unerupted tooth.

• The affected tooth is unerupted, so always

there is missing tooth during counting teeth
except if the milk tooth is still in place.

• There is swelling of the maxilla.

Plain x-ray ; shows there is an unerupted tooth

inside the cyst.

Treatment: excision by sublabial approach.

 B- dental cysts
• Cyst in relation to the apex of the
root of an infected tooth in an adult
may burst in the maxillary sinus
(antrum) lead to sinusitis.

• Bony swelling that may give eggshell

crackling sensation in large cysts.

• Normal count of the teeth.

X-ray: the tooth is outside the cyst.

Treatment: the cyst is removed through

a sublabial approach+ extraction of the
affected tooth to avoid recurrence.
 3-non odontogenic developmental cysts:

A-Nasopalatine cyst (incisive canal):

• It arises from the epithelial
remnants of the Nasopalatine duct
that connects the oral and nasal
cavities in the embryo.
• it presents as slowly enlarging
swelling in the anterior part of the
palate just behind the incisors.
• Secondary infection may occur .
plain x-ray : is diagnostic.
Treatment: excision.
 B-Nasolabial (naso-alveolar cyst):

(Kolstadt's Cyst)

• These developmental cysts are rare

lesions of the nasal alar region.

• They are generally thought to be of

embryonic origin, arising where nasal
epithelium became trapped in the
cleft formed by the fusion of the
maxillary, lateral, and medial nasal
processes.
• Nasolabial cysts are usually unilateral, more common in women, usually
present during the fourth and fifth decades of life and have a
predilection for the black population.

• They grow submucosally in the anterior nasal floor.

• often elevating and medially displacing the inferior turbinate.

• They expand downward into the gingivo-labial sulcus and laterally into
the soft tissue of the face.

• They are usually painless and asymptomatic, and they are recognized
only when they are acutely inflamed or large enough to cause nasal
obstruction. Sometimes their size will cause flattening of the Nasolabial
fold.
 Unilateral maxillary swelling

Traumatic: Hematoma, edema.

Inflammatory:
• Acute maxillary sinusitis , Fungal polyposis , Dento-alveolar infection.
Cyst:
• Dental cyst , Dentigerous cyst , Naso-alveolar cyst , Mucocele.
Benign lesions:
• Fibro-osseous dysplasia , osteoma , chondroma.
Locally malignant neoplasm:
Adamantinoma .osteoclastoma.

Malignant neoplasm:
• Squamous cell carcinoma , sarcoma.
 Thank you

To be continued