Median palatal cyst
SpecialtyOral and maxillofacial surgery

Median palatal cysts are uncommon hard palate fissural cysts that are not odontogenic. These lesions are located behind the incisive canal in the midline of the hard palate. The majority of the time, median palatine cysts are asymptomatic and are discovered by coincidence while a patient is being evaluated for a different ailment.[1]

Its genesis is commonly ascribed to the enclavement of epithelial remnants between the two lateral maxillary processes that fuse to form the hard palate, within the palatine suture.[2]

The median palatal cyst accounts for only 7.14% of all jaw cysts, making it a rare nonodontogenic lesion.[3]

Signs and symptoms

The most common clinical manifestation is painless, fluctuating swelling in the midline across the lingual surface of the palate.[4] Nonetheless, the majority of cases were unintentionally found during routine radiological or dental exams.[5] If the cyst develops an infection or if there is a localized involvement of the nasopalatine nerve, the cysts can get painful.[6]

Causes

According to the most widely accepted theory, it results from aberrant palatal development that occurs during embryogenesis.[1] The sixth fetal week is when the palatal shelves of the maxilla fuse together.[6] Entrapment occurs in the epithelium remnants that surround the two lateral maxillary processes which fuse to form the hard palate.[1] Later in adulthood, the epithelial remnants multiply and take on a cystic form for unclear reasons.[7] Others speculate that they are most likely primordial cysts of redundant dental lamina or extra tooth buds.[8] According to one author, it is more probable that median palatine cysts are nasopalatine cysts that have experienced an unusual amount of posterior displacement.[9]

Diagnosis

A 2001 paper by Hadi et al. provided precise diagnostic standards for midpalatal cysts.[7]

  1. The cyst needs to be located behind the palatine papilla.[7]
  2. The cyst needs to be grossly symmetrical in the palate's midline.[7]
  3. A cyst cannot be connected to a non-vital tooth or have any communication with an incisive canal.[7]
  4. It should be ovoid or round radiographically.[7]
  5. Histologically, the cyst wall should not have hyaline cartilage, large vascular spaces, or salivary glands.[7]

Treatment

Recurrence is uncommon after the cysts are treated with marsupialization or enucleation.[1]

Epidemiology

Just 7.14% of all jaw cysts are median palatal cysts.[3] Men were affected more frequently than women (4:1), and the age at diagnosis in the cases that have been reported thus far ranged from 20 to 50 years.[1]

See also

References

  1. 1 2 3 4 5 Gabe, Michael J.; Allmendinger, Andrew; Perone, Robert (July 5, 2009). "Median Palatine Cyst". Journal of Radiology Case Reports. EduRad. 3 (7): 7–10. doi:10.3941/jrcr.v3i7.269. ISSN 1943-0922. PMC 3303325. PMID 22470670.
  2. ↑ Queiroz, Thallita Pereira; Scartezini, Guilherme Romano; de Souza Carvalho, Abrahão Cavalcante Gomes; Luvizuto, Eloá Rodrigues; dos Santos, Pâmela Letícia; Hochuli-Vieira, Eduardo (2011). "Median Palatine Cyst". Journal of Craniofacial Surgery. Ovid Technologies (Wolters Kluwer Health). 22 (2): 737–740. doi:10.1097/scs.0b013e318208735d. ISSN 1049-2275. PMID 21415651.
  3. 1 2 Manzon, Steve; Graffeo, Michael; Philbert, Rawle (2009). "Median Palatal Cyst: Case Report and Review of Literature". Journal of Oral and Maxillofacial Surgery. Elsevier BV. 67 (4): 926–930. doi:10.1016/j.joms.2008.06.103. ISSN 0278-2391. PMID 19304060.
  4. ↑ Gingell, James C.; Levy, Bernard A.; DePaola, Louis G. (1985). "Median palatine cyst". Journal of Oral and Maxillofacial Surgery. Elsevier BV. 43 (1): 47–51. doi:10.1016/s0278-2391(85)80013-6. ISSN 0278-2391. PMID 3855318.
  5. ↑ Donnelly, Jerome C.; Koudelka, Brent M.; Hartwell, Gary R. (1986). "Median palatal cyst". Journal of Endodontics. Elsevier BV. 12 (11): 546–549. doi:10.1016/s0099-2399(86)80322-3. ISSN 0099-2399. PMID 3465862.
  6. 1 2 Cinberg, James Z.; Solomon, Marshall P. (1979). "Median Palatal Cyst". Annals of Otology, Rhinology & Laryngology. SAGE Publications. 88 (3): 377–381. doi:10.1177/000348947908800314. ISSN 0003-4894. PMID 464531. S2CID 11343206.
  7. 1 2 3 4 5 6 7 Hadi, U.; Younes, A.; Ghosseini, S.; Tawil, A. (2001). "Median palatine cyst: an unusual presentation of a rare entity". British Journal of Oral and Maxillofacial Surgery. Elsevier BV. 39 (4): 278–281. doi:10.1054/bjom.2001.0620. ISSN 0266-4356. PMID 11437424.
  8. ↑ Zachariades, N; Papanikolaou, S (1984). "The median palatal cyst: does it exist? Report of three cases with oro-medical implications". Journal of Oral Medicine. 39 (3): 173–176. PMID 6592299.
  9. ↑ Rapidis, Alexander D.; Langdon, John D. (1982). "Median cysts of the jaws — not a true clinical entity". International Journal of Oral Surgery. Elsevier BV. 11 (6): 360–363. doi:10.1016/s0300-9785(82)80059-8. ISSN 0300-9785. PMID 6820008.

Further reading

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