Retention cysts in maxillary sinus

[Ber Rabbit]

What effect can these fluid filled cysts have on diving? The sinus passage is not blocked by them at this time, they are sitting in the bottom of the sinus. I've never had any trouble with my sinuses in the 10 years I've been diving. Has anyone heard of any treatment other than surgery to get a fluid filled cyst to shrink or just go away?
Thanks!
Ber

 

[John Reinertson]

Generally, these are things we ignore unless they create problems.
They are thought to be more common in people that have sinus problems, but the cysts themselves are often asymptomatic and are often ignored.

Whether or not they should be treated is up to you and your physician in your case, but it's not one of those things that almost always has to have something done to it.

(As opposed to broken hips, heart attacks, etc.)


John

 

[Ber Rabbit]

In this part of Ohio you're abnormal if you don't have sinus problems I just wanted to make sure he didn't make a mistake by clearing me to dive, I really don't want to have surgery but I don't want to rupture a sinus either. He told me to let him know if I ever have any problems when I dive because then I'll HAVE to have the cysts removed. He'd still like to see me go ahead and have it done to head off any future problems but since I don't get many sinus infections (I've only had 1 that I know of) and my sinuses clear when I dive I'd rather just leave well enough alone. He just thought it odd that I've NEVER been able to blow my nose, I think that's why he ordered the CT scan. I can "snort & swallow" to clear my sinuses but even when I'm completely plugged up I can only blow out the stuff that's already starting to drip.

Thanks for the info!
Ber

 

[budgy]

Hi Ber Rabbit,
Its good to see you again on the boards
For many years I had a lot of sinus problems, one side or other or both was always blocked, it was like I had a ball valve between the eyes, I could change the side that was blocked; if I lay on my side the ball would fall and close the lower nasal passage. I used nasal sprays liberally, ate my limit of actifed and sinatabs re-inforced with packets of hacks and fishermans friends. The doc said the damp climate was responsible but when I moved to the dry of the South African high veldt my new doc said the problem was caused by the dry air. I saw specialists had allergy tests and a nose operation, it wasn't successful.
See if you can get a book by Geoff Pike "The Power of Chi" Bay Books London, or "The eight pieces of brocade" Dr. Yang Jwing -Ming, YMAA publication center. In 1992 I tried a traditional Chinese preventative medicine program of gentle health exercise based on relaxation concentration and breathing called Ba Duann Gin. For me the sinus problem cleared up after a couple of months of practice, I still get up in the morning partially blocked but by the time I clean my teeth I am clear. Over the last 10 years I think I have had better immunity to colds and flu. I have got a bit lazy about regular practice lately, but thats life.
P.S. I don't think the program is suitable for cough and chokers.

 

[Ber Rabbit]

Glad to be back! It's still a little nuts here so I don't get to spend much time on the board yet.

Thanks for the info! Right now I'm taking alfalfa tablets, my dad swears by them. He took prescription sinus meds for years but after he started taking the alfalfa he was able to get off of them completely. They keep my sinus headaches to a minimum pain level. I'll have to try to get a copy of those books, sounds like interesting reading.
Ber

 

[Laurence Stein DDS]

Ber Rabbit,

In my dental practice, it is rather common to find these in the maxillary sinus. Usually, they don't do anything--I advise the patient and if it becomes a problem, refer to an ENT.

One thing you should check out before any surgery (if contemplated) is get a good dental check up. An infected tooth or deep gum pocket near the maxillary sinuses can cause a thickening of the sinus membrane and "look" like a retention cyst. The tooth does not have to hurt...er...yet.

If the probem is dental, the solution is probably easier than sinus surgery. At least rule it out. The x-ray views used by ENTs do not visualize the dental apparatus well.

Just my 2 cents.

Larry Stein

 

[Ber Rabbit]

Would the normal dental x-rays show this? I go every 6 months for my check-up like a good little rabbit and he's never mentioned any problems. I did have the "full head" x-ray done when I first started seeing this dentist about 3 years ago. He asked if I had any concerns and I said I had a blue spot on my gum beside a big filling. He did a full x-ray and found that I had been "tattooed" when that filling was done. Would the cysts have shown up on that x-ray, I'm guessing this is something I've had for years not something that recently formed but I could be wrong.

My doctor found the cysts via CAT scan, does that make a difference in what they are able to see?

Thanks for the info!
Ber

 

[Laurence Stein DDS]

Ber Rabbit,

Standard check up x-rays probably won't show a retention cyst. a Panoramic x-ray (it goes around your head likely will). The CT scan will show the cyst.

I just didn't want you to leave any simple stone unturned. I see these cysts all the time on new patients who have panoramic radiographs. Sometimes part of the cyst will show on the smaller dental x-rays but usually not enough for the dentist to "appreciate" its presence.

Since only about 30% of Americans see the dentist regularly, I thought it might be appropriate to suggest the exam. Since you are in that 30%, congratulations.

Occasionally, a dental infection extends into the sinus. While pain is usual, it doesn't always happen. Since you seem to have taken the appropriate steps in treatment, I think you should follow your doctor's advice.

Good luck--hope you can avoid the surgery.

Larry Stein

 

[Ber Rabbit]

The panoramic x-ray was the thing I had that revealed the "tattoo." He was so concerned about finding the reason for the blue spot he probably didn't look at any other part of the x-ray. Right now the ruling is if the cyst doesn't bother me when I dive I don't need anything done--YEAH!! It can't be too bad, he said it could cause recurring sinus infections and even though I work in a relatively dusty environment and my co-workers almost always have a sinus infection I remain infection free (knock-on-wood!).

I've been lucky enough to find a dentist I really like! My husband had been seeing him for a while and took me in to meet him. Having a cool dentist makes all the difference in the world! Heck, we even invited him to the wedding and happily he took us up on the invitation.

Thanks for the help!
Ber

 

[Laurence Stein DDS]

Ber Rabbit,

You're into tatoos!!!? You gotta anchor on your forearm?

Seriously, who found the tatoo. Usually, if a dentist finds it, he knows it's an amalgam tatoo. They almost never show on x-ray except if truely a lot of metal has been driven into the tissue during the removal of an old filling.

If the ENT found the bluish tatoo, we would probably be more concerned. It appears as a bluish, pigmented area on the gum next to and existing or missing tooth. Since pigmented lesions are suspect, be glad he was able to make out the metallic pieces on the x-ray. Otherwise he would suggest a biopsy.

Regards,


Larry Stein