I have had chronic sinusitus for the past year and a half or so. I changed primary care doctors recently, and the most recent xray suggests a mucous cyst. I am taking Flonase, and was administered a cortisone shot as well. I will be sent to an ENT doctor, but I was wondering what a mucous cyst is. Is it similar to a pimple? Could it be something malignant?
Thanks
Answer -----------
Mucous retention cysts are fluid-filled cysts typically seen in the floor of the maxillary sinuses (which are the large sinuses located in either cheek). In the vast majority of cases, they do not require surgical removal and are felt to be clinically insignificant. In fact if 100 individuals who had no sinus symptoms were to have x-rays of their sinuses, as many as 10-15 might be found to have mucous retention cysts. It is therefore unlikely that the finding of mucous retention cysts on an x-ray has any causative relationship to the symptoms you describe as "chronic sinusitis" and it is also unlikely that surgical intervention directed at removal of such cysts will result in improvement of your symptoms.
Surgical removal of mucous retention cysts might be indicated if the cysts are large enough to obstruct the small opening of the sinus (which is located near the TOP of the sinus); if the cysts are associated with obvious thinning or destruction of bone on x-ray; or if there are well-localized symptoms associated with the cyst (eg facial pressure or pain located directly over the cyst). However, these surgical indications for cyst removal are very uncommon. Generally, a CT scan as opposed to a standard sinus x-ray would be necessary to determine whether surgical removal of a sinus cyst is necessary. I would again emphasize that it is RARELY necessary to surgically remove such cysts, even when there are chronic nasal or sinus symptoms present.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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