[Potentials for the endonasal endoscopic surgery in the treatment of maxillary cysts]

To evaluate efficacy of endoscopic surgery in the treatment of maxillary cysts (MC), 152 operations in 134 patients were analysed. Besides MC, 91% of the patients had additional involvement of the nasal cavity and middle nasal passage which required surgery. By computer tomography data, all the cysts were divided into four groups by wall location: posteroinferior, superior, lateral, medial or anterior. Such division is important for the choice of the surgical approach: cysts of the first three locations can be easily removed through the middle nasal passage, in medial and anterior cysts this approach is effective only in half the cases. In the rest cases the sinus was opened through the anterior wall. In all, removal of the cyst by the endonasal approach proved feasible in 73.7%, by the anterior wall--in 26.3% of cases. The algorithm proposed for the choice of optimal intervention implies the initial use of the external approach only in MC located on the anterior and medial walls in the absence of concomitant lesions. In all the other cases, surgery should begin with partial resection of the unciform process and revision of the natural anastomosis of the sinus.