Giant maxillary radicular cyst: Case report

Abstract

Introduction: Radicular cysts are the most common odontogenic cysts, usually small and asymptomatic, but occasionally enlarge enough to distort facial contours and obstruct the nasal airway.

Case report: A 35‑year‑old man presented with progressive right maxillary swelling and nasal obstruction. Examination showed a firm bony mass effacing the nasolabial and palpebro‑jugal folds and deforming the right nostril threshold. CT revealed a well‑defined, expansile intramaxillary cyst extending into both nasal cavities and the right orbital floor without aggressive features. Histopathology confirmed a radicular cyst. The lesion was excised via a wide paralateronasal Weber–Ferguson approach with anterior maxillary osteotomy. Careful dissection along the orbital floor allowed complete enucleation without the need for reconstruction. Recovery was uneventful; at six months the patient had restored jugal projection and improved bilateral nasal airflow.

Discussion: While most radicular cysts are managed conservatively, very large lesions risk displacement of the nasal cavity and orbit and may require open approaches for safe extraction. This case illustrates indications for radical access, key operative steps, and favourable functional and aesthetic outcomes after complete enucleation.