Treatment of an Extensive Maxillary Cyst Using Nasal Airway and Balloon Catheter Devices

Introduction. Large maxillary cysts occasionally expand into the maxilla and erode the maxillary sinus and nasal cavity. The Caldwell-Luc procedure is the recommended treatment for large maxillary sinus cysts. However, it is hard to preserve the nasal space in the case of large maxillary sinus cysts that penetrate into the nasal cavity. Methods. A 22-year-old man who had large maxillary sinus cysts was referred to our department for a surgical treatment. After removing the cyst from the maxillary sinus using the Caldwell-Luc procedure, we used nasal airway and balloon catheter devices to preserve the space of the inferior nasal meatus and maxillary sinus. These devices were removed 10 days postoperatively. Insertion and removal of both devices were simple and painless. Findings. The nasal airway and balloon catheter devices were useful for performing maxillary sinus surgery to remove large cysts. Our method was satisfactorily safe and was an effective minimally invasive treatment that preserved the space of the inferior nasal meatus and maxillary sinus. 1. Introduction Among large maxillary cysts that expand to the maxillary sinus, dentigerous cysts, and radicular cysts are two main odontogenic cysts [1]. In the oral and maxillofacial regions, cyst enucleation combined with the Caldwell-Luc procedure [2, 3], which has been the mainstay of maxillary sinus surgery over the past century, was adopted for their treatment [4]. In this report, we describe a new method to treat maxillary cysts that have expanded into the maxilla, the maxillary sinus, and the nasal cavity using nasal airway and balloon catheter devices after the Caldwell-Luc procedure. 2. Case Presentation A 22-year-old man suffering from complete nasal obstruction for the last 5 months was referred to our department. Computed tomography scan showed impacted teeth along with the radiopaque borders in bilateral maxillary sinuses (Figure 1). To remove the large maxillary sinus cysts and preserve the space of the inferior nasal meatus and maxillary sinus, surgical enucleation for the cysts was performed according to the Caldwell-Luc procedure [2–4]. After removing the cysts from the maxillary sinus, we created a nasoantral window in the lateral nasal wall as described previously [2, 3] and a hole at the same position as the nasoantral window in the nasal airway device (Figure 2(a) arrow). The maxillary sinus was packed with the balloon catheter, instead of a gauze tampon, through the lateral hole of the nasal airway (Figures 2(b), 2(c), and 3). These devices were removed 10 days postoperatively. A