Surgical outcomes between two endoscopic approaches for maxillary cysts

Area of Science:

• Otolaryngology
• Surgical Innovation
• Sinus Surgery

Background:

• Symptomatic maxillary sinus Retention Cysts (RCs) pose a clinical challenge.
• Surgical interventions aim to provide symptomatic relief and prevent recurrence.
• Comparing different surgical approaches is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare the efficacy of Middle Meatus Antrostomy (MMA) alone versus Inferior Meatus Antrostomy (IMA) with basal mucosa electrocoagulation for treating symptomatic maxillary RCs.
• To evaluate differences in recurrence rates, symptomatic relief, and antrostomy closure between the two surgical techniques.

Main Methods:

• A randomized controlled trial involving patients with symptomatic unilateral maxillary RCs.
• Patients were allocated to either MMA (n=54) or IMA with electrocoagulation (n=53).
• Outcomes including symptomatic relief, cyst recurrence, and antrostomy closure were assessed at 12 months postoperatively.

Main Results:

• Both MMA and IMA provided similar symptomatic relief, with no statistically significant difference in symptomatic failure rates (16.7% vs 7.5%, p=0.251).
• IMA demonstrated a significantly lower postoperative cyst recurrence rate (1.9%) compared to MMA (29.7%, p<0.0001).
• Antrostomy closure rates differed significantly (13.0% for MMA vs 32.1% for IMA, p=0.032), but did not correlate with recurrence or failure.

Conclusions:

• IMA combined with basal mucosa electrocoagulation and MMA alone yield comparable symptomatic relief for maxillary RCs.
• IMA offers advantages of shorter operation times and substantially reduced postoperative recurrence rates.
• IMA represents a potentially more effective surgical option for managing symptomatic maxillary sinus RCs.