Nasopalatine duct cyst

The nasopalatine duct cyst (NPDC) occurs in the median of the palate, usually anterior to first molars. It often appears between the roots of the maxillary central incisors. Radiographically, it may often appear as a heart-shaped radiolucency. It is usually asymptomatic, but may sometimes produce an elevation in the anterior portion of the palate. It was first described by Meyer in 1914.[1]

Nasopalatine duct cyst
Identical images with heart-shaped radiolucency highlighted in right film.
SpecialtyOral and maxillofacial surgery

The median palatal cyst has recently been identified as a possible posterior version of the nasopalatine duct cyst.

Signs and symptoms

Nasopalatine duct cysts usually present as asymptomatic palatal swellings, but they may rarely be accompanied by pain and/or purulent discharge.[2]

Cause and diagnosis

Historically, the cause of nasopalatine duct cysts has been somewhat of an enigma. Although it was originally postulated that the cyst formed from trapped epithelial cells during embryonic fusion of the palatal bones,[3] it is now thought that it forms from oronasal ducts present within the incisive canals.[4][5]

As a cyst, the nasopalatine duct cyst requires histological analysis for a definitive diagnosis. Radiographically, the nasopalatine cyst appears as a well-demarcated round, ovoid, or heart-shaped structure presenting in the midline of the maxilla.[6]

Treatment

The cysts are generally treated by excision.

Epidemiology

The nasopalatine cyst is the most common non-odontogenic cyst of the oral cavity, at an estimated occurrence rate of 73%.[7]

References
  1. Meyer, AW. A unique supernumerary paranasal sinus directly above the superior incisors. J Anat 1914;48:118-129.
  2. Vasconcelos, RF, et al. Retrospective analysis of 31 cases of nasopalatine duct cyst. Oral Dis 1999;5:325-328.
  3. Albayram, MS, et al. Radiology quiz case: Nasopalatine duct cyst. Arch Otolaryngol Head Neck Surg 2001;127:1283-1285.
  4. Gnanasekhar, JD, et al. Misdiagnosis and mismanagement of a nasopalatine duct cyst and its corrective therapy: A case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995;80:465-470.
  5. Swanson, KS, et al. Nasopalatine duct cyst: An analysis of 334 cases. J Oral Maxillofac Surg 1991;49:268-271.
  6. Elliott, KA, et al. Diagnosis and surgical management of nasopalatine duct cysts. Laryngoscope 2004;114:1336-1340.
  7. Daley TD, et al. Relative incidence of odontogenic tumors and oral and jaw cysts in a Canadian population. Oral Surg Oral Med Oral Pathol 1994;77:276-280.
Classification
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