J Rhinol.  2018 Nov;25(2):114-117. 10.18787/jr.2018.25.2.114.

A Case of Secondary Trigeminal Neuralgia Caused by Infected Postoperative Maxillary Cyst

• Lee SM
• Sung HK
• Kang JC
• Kim HJ

• KMID: 2431226
• DOI: http://doi.org/10.18787/jr.2018.25.2.114

Abstract

Postoperative maxillary cyst (POMC) is relatively common complication among patients who underwent Caldwell-Luc surgery. Patients with POMC usually have no symptoms, although cyst extension can result in bone destruction or cystic infection with pain. The trigeminal nerve consists of the ophthalmic nerve, maxillary nerve, and mandibular nerve. Among these branches, the maxillary nerve runs to the lateral and frontal sides of the maxillary sinus wall. POMC can rarely lead to trigeminal neuropathy caused by cyst enlargement that compresses some branches of the trigeminal nerve. Recently, we experienced a case with trigeminal neuralgia due to POMC. The patient was successfully treated with inferior meatal antrostomy. We report this rare case with a literature review.

Keyword

Trigeminal neuralgia; Maxillary sinus; Postoperative maxillary cyst; Postoperative cheek cyst

MeSH Terms

Humans
Mandibular Nerve
Maxillary Nerve
Maxillary Sinus
Ophthalmic Nerve
Pro-Opiomelanocortin
Trigeminal Nerve
Trigeminal Nerve Diseases
Trigeminal Neuralgia*
Pro-Opiomelanocortin

Figure

• 

  Fig. 1 Images of paranasal sinus CT. A: Bone setting of coronal view shows a 1.8 cm-sized cystic lesion with bone remodeling (arrow) at the postoperative right maxillary sinus. B: Enhanced image shows fat infiltration and inflammatory changes (short arrow) on bony dehiscence side of postoperative maxillary cyst (long arrow). C: Pterygomaxillary fissure (asterisk) is observed upper side of bony dehiscence site at coronal image.

• 

  Fig. 2 Cranial nerve MR image. Axial view of T2 weighed image shows 1.8 cm sized cystic lesion with bony dehiscence at the right maxillary sinus. And cyst bulging at the bony dehiscence site (long arrow) and infiltration (short arrow) around right maxillary sinus lateral wall were observed.

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