Chemical Composition of Fluids from Benign Cysts of the Antrum

The maxillary sinus may be the site of several types of benign cysts; this report deals only with the non-secreting type. These cysts form in the connective tissue of the antrum mucosa and are lined by loose connective tissue which contains many capillaries, along with numbers of leucocytes and reticulo-endothelial cells. These cysts vary considerably in size and require a period of weeks or months to develop to the point where they fill the antrum. They contain a clear fluid which coagulates rapidly after removal and has a yellow or amber tinge. Little is known about the formation of these cysts or why they produce such definite symptoms in a patient. It was thought, therefore, that chemical analyses of the fluid obtained from these cysts might contribute some useful knowledge. Experimental. The presence of the non-secreting cyst was determined by X-ray films of the sinus, which showed a large, rounded, soft-tissue mass lying in the maxillary sinus. To obtain the fluid from the cyst and to reach the anterior part of the sinus the antrum is punctured with a curved trocar and cannula. Because the cyst may lie anteriorly, the method of puncture must permit exploration of the anterior and inferior region of the sinus as well as posteriorly. The cyst may regress after puncture and lavage. Recurrent or large cysts require surgical removal. The volume of fluid obtained varied from 2 to 10 cc, depending upon the size of the cyst and the efficiency of the puncture. The specimens were always clear with a yellow tinge and always clotted. The fibrin was removed by twirling on a glass rod and the clear filtrate was used for all analyses. The fluids used for pH and CO2 determinations were collected under oil.