FUNCTIONAL EXAMINATION METHODS IN PATIENTS WITH MAXILLARY SINUS CYSTS

Abstract

Background: Maxillary sinus cysts are common radiologic findings, but only a subset of lesions is associated with clinically meaningful sinonasal dysfunction. Objective: To evaluate the diagnostic value of functional examination methods in 120 patients with maxillary sinus cysts and to identify the most informative battery for clinical assessment and treatment planning. Methods: This modeled clinical study included 120 patients with CT- or CBCT-confirmed maxillary sinus cysts. Functional assessment consisted of visual analogue scale scoring, SNOT-22, peak nasal inspiratory flow, active anterior rhinomanometry, acoustic rhinometry, psychophysical smell testing, saccharin transit time, and nasal endoscopy. Results: Mean VAS scores were 4.8 ± 2.1 for nasal obstruction, 4.1 ± 2.0 for facial pressure, and 3.2 ± 2.3 for smell disturbance. Mean SNOT-22 was 34.6 ± 15.8, mean PNIF was 95.7 ± 22.4 L/min, and mean bilateral rhinomanometric resistance was 0.34 ± 0.09 Pa/cm³/s. Symptomatic patients demonstrated significantly worse SNOT-22, lower PNIF, higher resistance, smaller minimal cross-sectional area, longer saccharin transit time, and more frequent olfactory dysfunction than minimally symptomatic patients. Conclusion: Functional evaluation of maxillary sinus cysts should be multimodal. The most informative core battery combines symptom scores, SNOT-22, PNIF, smell testing, and endoscopic correlation, with rhinomanometry, acoustic rhinometry, and mucociliary clearance testing used selectively.