Principal Clinical Factors Predicting Therapeutic Outcomes After Surgical Drainage of Postoperative Cheek Cysts: Experience From a Single Center
1
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Objectives. Postoperative cheek cyst (POCC) is a late postoperative complication of radical maxillary sinus surgery including the Caldwell-Luc (C-L) operation. The present study aimed to evaluate the therapeutic outcomes of surgical treatment for POCC and to assess the clinical factors correlated to these outcomes. Methods. This study included 57 patients (67 nostrils) diagnosed with POCC who underwent surgical drainage. The medical records of the patients were retrospectively reviewed for radiological findings, treatment modalities, residual symptoms, and recurrences. Results. In total, 30 patients were male and 27 patients were female with a mean age of 55 years, and the patients were usually diagnosed with POCC 28.2 years after radical surgery. Endonasal endoscopic marsupialization was performed via inferior meatal antrostomy, and if possible, middle meatal antrostomy was performed at the same time. In patients with cysts that were difficult to reach using an endonasal endoscopic approach, additional open C-L approaches were performed. The median follow-up period was 19.4 months. Overall, adequate drainage and symptomatic relief were achieved in 91% (61/67) of the patients. The recurrence rate was significantly higher in patients who had anterolateral POCC. Failure to achieve symptomatic relief was correlated to a smaller cyst and the use of the open C-L approach for drainage. Conclusion. The location and size of the cyst as well as the use of the open surgical approach were important factors in predicting the therapeutic outcome of POCC. The time point of treatment and surgical approaches should be based on the above-mentioned findings.
Abstract
Objectives. Postoperative cheek cyst (POCC) is a late postoperative complication of radical maxillary sinus surgery including the Caldwell-Luc (C-L) operation. The present study aimed to evaluate the therapeutic outcomes of surgical treatment for POCC and to assess the clinical factors correlated to these outcomes. Methods. This study included 57 patients (67 nostrils) diagnosed with POCC who underwent surgical drainage. The medical records of the patients were retrospectively reviewed for radiological findings, treatment modalities, residual symptoms, and recurrences. Results. In total, 30 patients were male and 27 patients were female with a mean age of 55 years, and the patients were usually diagnosed with POCC 28.2 years after radical surgery. Endonasal endoscopic marsupialization was performed via inferior meatal antrostomy, and if possible, middle meatal antrostomy was performed at the same time. In patients with cysts that were difficult to reach using an endonasal endoscopic approach, additional open C-L approaches were performed. The median follow-up period was 19.4 months. Overall, adequate drainage and symptomatic relief were achieved in 91% (61/67) of the patients. The recurrence rate was significantly higher in patients who had anterolateral POCC. Failure to achieve symptomatic relief was correlated to a smaller cyst and the use of the open C-L approach for drainage. Conclusion. The location and size of the cyst as well as the use of the open surgical approach were important factors in predicting the therapeutic outcome of POCC. The time point of treatment and surgical approaches should be based on the above-mentioned findings.
참고문헌 (19)
- Kaneshiro S, "The postoperative maxillary cyst : report of 71 cases", J Oral Surg, 39(3), pp.191~198 (1981)
- Yamamoto H, "Clinicopathologic study of the postoperative maxillary cyst", Oral Surg Oral Med Oral Pathol, 62(5), pp.544~548 (1986)
- Nishioka M, "Prevalence of postoperative maxillary cyst significantly higher in Japan", Oral Med Pathol, 10(1), pp.9~13 (2005)
- 이경철, "Comparison of Clinical Characteristics between Primary and Secondary Paranasal Mucoceles", Yonsei Medical Journal, 51(5), pp.735~739 (2010), 연세대학교의과대학
- Macbeth R, "Caldwell, Luc, and their operation", Laryngoscope, 81(10), pp.1652~1657 (1971)
- Kubo I, "A buccal cyst occurring after a radical operation of the maxillary sinus", Z Otol Tokyo, 33, pp.896~897 (1927)
- 장태영, "비내시경수술을 이용한 술 후 상악동 점액낭종의 치료", 대한이비인후-두경부외과학회지, 48(3), pp.314~319 (2005), 대한이비인후과학회
- Kwon SH, "Surgical treatment and clinical study of postoperative maxillary cyst", Korean J Otorhinolaryngol Head Neck Surg, 40(8), pp.1115~1121 (1997)
- Yoshikawa Y, "Effective treatment of the postoperative maxillary cyst by marsupialization", J Oral Maxillofac Surg, 40(8), pp.487~491 (1982)
- Busaba NY, "Maxillary sinus mucoceles : clinical presentation and long-term results of endoscopic surgical treatment", Laryngoscope, 109(9), pp.1446~1449 (1999)
- Huang CC, "Transnasal endoscopic marsupialization of postoperative maxillary mucoceles : middle meatal antrostomy versus inferior meatal antrostomy", Eur Arch Otorhinolaryngol, 268(11), pp.1583~1587 (2011)
- Saito T, "Implications of endoscopic endonasal surgery for the treatment of postoperative maxillary mucoceles", ORL J Otorhinolaryngol Relat Spec, 62(1), pp.43~48 (2000)
- Sawatsubashi M, "Transnasal endoscopic surgery of post-operative maxillary cysts", J Laryngol Otol, 2, pp.S46~51 (2015)
- Nakamura K, "Endoscopic endonasal surgery for postoperative maxillary cyst", Nihon Jibiinkoka Gakkai Kaiho, 98(6), pp.984~988 (1995)
- Lund VJ, "Fundamental considerations of the design and function of intranasal antrostomies", Rhinology, 23(3), pp.231~236 (1985)
- Low WK, "Complications of the Caldwell-Luc operation and how to avoid them", Aust N Z J Surg, 65(8), pp.582~584 (1995)
- Robinson SR, "The incidence of complications after canine fossa puncture performed during endoscopic sinus surgery", Am J Rhinol, 19(2), pp.203~206 (2005)
- Thompson LD, "Paranasal sinus mucocele", Ear Nose Throat J, 91(7), pp.276~278 (2012)
- Abdel-Aziz M, "Maxillary sinus mucocele : predisposing factors, clinical presentations, and treatment", Oral Maxillofac Surg, 21(1), pp.55~58 (2017)