Three-dimensional images contribute to the diagnosis of mucous retention cyst in maxillary sinus

Abstract

Objective: To evaluate the detection of mucous retention cyst of maxillary sinus (MRCMS) using panoramic radiography and cone beam computed tomography (CBCT).

Study design: A digital database with 6,000 panoramic radiographs was reviewed for MRCMS. Suggestive images of MRCMS were detected on 185 radiographs, and patients were located and invited to return for follow-up. Thirty patients returned, and control panoramic radiographs were obtained 6 to 46 months after the initial radiograph. When MRCMS was found on control radiographs, CBCT scans were obtained. Cysts were measured and compared on radiographs and scans. The Wilcoxon, Spearman and Kolmorogov-Smirnov tests were used for statistical analysis. The level of significance was set at 5%.

Results: There were statistically significant differences between the two methods (p<0.05): 23 MRCMS detected on panoramic radiographs were confirmed by CBCT, but 5 MRCMS detected on CBCT images had not been identified by panoramic radiography. Eight MRCMS detected on control radiographs were not confirmed by CBCT. MRCMS size differences from initial to control panoramic radiographs and CBCT scans were not statistically significant (p= 0.617 and p= 0.626). The correlation between time and MRCMS size differences was not significant (r = -0.16, p = 0.381).

Conclusion: CBCT scanning detect MRCMS more accurately than panoramic radiography.

Figure 1

Measurement of MRCMS on panoramic radiograph A) and on coronal B), axial C) and sagittal D) CBCT reconstructions of same patient.

Figure 2

Control panoramic radiograph of bilateral MRCMS A), sagittal CBCT reconstruction of same patient, with no MRCMS in right side B) and MRCMS in left side C).

Figure 3

A) Control panoramic radiograph with MRCMS in right side and coronal CBCT reconstruction confirming MRCMS in right side and showing another MRCMS in left side. B) Control panoramic radiograph with MRCMS in left side and coronal CBCT reconstruction of same patient with bilateral MRCMS.