Large Follicular Cyst Associated with Upper Third Molar in the Maxillary Sinus with Pterygomaxillary Space Extension: Reflection on a Case Report

Carmelo Lo Faro; Vincenzo Santillo; Giorgio Lo Giudice; Antonio Troiano; Marco Montella; Salvatore D'Amato; Gianpaolo Tartaro

doi:10.3889/oamjms.2021.5624

Authors

Carmelo Lo Faro Department of Neurosciences, Maxillofacial Surgery Unit, Reproductive and Odontostomatological Sciences, University of Naples “Federico II,” Naples, Italy
Vincenzo Santillo Department of Medical-Surgical and Dental Specialities, Oral and Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli,” Caserta, Naples, Italy
Giorgio Lo Giudice Department of Neurosciences, Maxillofacial Surgery Unit, Reproductive and Odontostomatological Sciences, University of Naples “Federico II,” Naples, Italy
Antonio Troiano Department of Neurosciences, Maxillofacial Surgery Unit, Reproductive and Odontostomatological Sciences, University of Naples “Federico II,” Naples, Italy
Marco Montella Department of Mental and Physical Health and Preventive Medicine, Pathology Unit, University of Campania “Luigi Vanvitelli,” Caserta, Naples, Italy
Salvatore D'Amato Department of Medical-Surgical and Dental Specialities, Oral and Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli,” Caserta, Naples, Italy
Gianpaolo Tartaro Department of Medical-Surgical and Dental Specialities, Oral and Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli,” Caserta, Naples, Italy

DOI:

https://doi.org/10.3889/oamjms.2021.5624

Keywords:

Giant follicular cyst, Dentigerous cyst, pterygo-maxillary space, cone beam computer tomography, Caldwell-Luc technique

Abstract

BACKGROUND: Follicular cysts are osteolytic lesions characterized by greater growth, differentiation, and degeneration potentials, compared to inflammatory root cysts. Those connected to upper third molars can disrupt the neighboring teeth and extend to maxillary sinus and adjacent anatomical structures.

CASE PRESENTATION: In this study, we present a case of a large dimension follicular cyst associated with the upper third molar, extended to maxillary antrum and pterygomaxillary space, uncommon for dimensions, involving meso- and sovra-structure describing the clinical diagnostic procedures, and the surgical strategies adopted. The cone-beam computed tomography allowed a very accurate analysis of the lesion. Surgical excision was performed through Caldwell-Luc technique, approaching to the pterygomaxillary space. A 1-year follow-up shows good clinical, anatomical, and functional conditions. Histological examination confirmed the diagnosis of follicular cyst.

CONCLUSION: Giant follicular cysts require an accurate pre-operative study due to the delicate structures that may be involved.

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