Surgical ciliated cyst 12 years after Le Fort I maxillary advancement osteotomy: a case report and review of the literature

The surgical ciliated cyst, which is also known with the terms ‘post-operative maxillary cyst (PMC)’ or ‘paranasal cyst’, was originally reported by Kubo in 1927 and well-described in Japanese literature since the 1980s. PMC is a locally aggressive lesion that appears as a long-term delayed complication, arising from years to decades, after surgery or trauma in the maxillary sinus region such as midfacial osteotomies and fractures or orthognatic surgery. Although this cyst is rarely reported in Western population, it constitutes 20% of oral cysts in Japan. PMC usually appears as a swelling that may cause expansion of vestibular, palatine or both bone cortical plates, and pain in the adjacent facial area of buccal vertical releasing incisions; formation of fistulas has also been reported. In case of significant cyst growth, other symptoms may include nasal obstruction, rhinorrhea, dysomia, exophthalmos and ocular displacement. We report the only case of a surgical ciliated cyst that developed in a Caucasian patient 12 years after a Le Fort I maxillary advancement osteotomy.