Surgical Ciliated Cyst of the Left Maxilla - A Case Report of Unusual Pathogenesis

Surgical ciliated cyst (SCC) is a type of true epithelial lined antral cysts, which mostly occurs in maxilla from the sinonasal mucosa and gland, comprising 20% of all oral cysts in Japan. It is also called as postoperative maxillary cyst or postoperative paranasal cyst. The etiology is believed to be post trauma or surgery in the region of maxillary antrum.

Patient's concern is less evident in this cystic pathology, because this cyst even though an aggressive cyst, presents with fewer symptoms that can be uncomfortable to the patient or push them to seek medical attention. Often, this becomes an incidental finding during routine postoperative follow-up.

The rationale behind this report is to emphasize even a traumatic extraction of tooth can damage the floor of the sinus and lead to the cyst formation.

We report a case of SCC in a 76-year-old female of the left maxillary sinus possibly after a traumatic extraction of the tooth, for which enucleation of the cyst was done as a primary modality of treatment.

Diagnosis was made after a computed tomography (CT) scan and incisional biopsy. Diagnosis of such rare cases poses a great challenge due to its paucity in etiology, and it often requires a CT scan that becomes an essential gold standard investigation.

Patient is currently under one year follow up and without any signs of recurrence.

It should be acknowledged that tampering trauma or with sinus mucosa can trigger the formation of a SCC of the maxilla, and it should always be considered as a possible sequel after any procedure of such potential in the maxilla.