Endoscopic management of uncommon benign maxillary sinus lesions: a case series

Benign maxillary sinus lesions, such as fibrous dysplasia, osteoma, ameloblastoma, and dentigerous cysts, are uncommon and may be misinterpreted as chronic rhinosinusitis due to overlapping clinical characteristics. A combination of histopathological evaluation and imaging is essential to achieve an accurate diagnosis and guide appropriate surgical intervention.

This case series presents four patients ranging in age from 27 to 41 years, each diagnosed with a distinct benign maxillary sinus lesion. The patients presented with different symptoms including nasal blockage, postnasal drip, and facial discomfort. Radiologic evaluation demonstrated four unique lesion patterns: fibro-osseous growth, calcified masses, cystic changes with ectopic teeth, and solid expansile tumors. Three patients were managed with endoscopic sinus surgery, while one required open resection due to tumor recurrence and bony involvement. Histopathological examination confirmed the diagnoses of bilateral dentigerous cysts, ameloblastoma, fibrous dysplasia, and benign osteoid lesion, respectively.

Although uncommon in otorhinolaryngology practice, benign maxillary sinus lesions carry important diagnostic and therapeutic implications. Endoscopic techniques provided effective management in the majority of patients, reducing morbidity while preserving normal anatomical structures. However, open surgery and interdisciplinary planning could be required for locally aggressive tumors, such as maxillary ameloblastomas. Each case highlights the importance of individualized management based on radiographic extent, recurrence risk, and lesion behavior. Despite their rarity, benign maxillary sinus lesions should be considered in individuals with atypical or refractory sinonasal symptoms. Accurate histopathological analysis combined with thorough radiologic evaluation remains necessary. While endoscopic approach is generally successful, open resection should be reserved for complicated or recurrent cases.