Surgical ciliated cysts (SCC) are rare entities that were first described in the Japanese literature after treatment for chronic maxillary sinusitis. Classically associated with surgery to the maxillary sinus, they have also been reported in association with orthognathic surgery, bone grafting, and trauma. These lesions can develop from a few months up to several years after the surgical procedure. The authors report 2 new cases of SCC after a LeFort I osteotomy for class III dentofacial deformity correction. One of them presented with bilateral lesions and suffered from a recurrence after 5 years, 2 rare events associated with SCC. A review of the literature of the past 5 years was undertaken, in order to ascertain the reported time of follow-up and recurrence. A PubMed search retrieved a total of 15 articles with 17 cases reported. Nine cases were associated with orthognathic surgery, 4 with Caldwell-Luc procedures, 2 with sinus lift and 2 with trauma. The mean follow-up after removal of the SCC was of 8.6 months. Four cases did not specify the follow up time; 1 case was lost to follow-up. No relapses were reported. Like what happens with the primary lesion, a recurrence can take place several years after removal. It is the authors’ opinion that adequate long-term follow-up must be granted for a timely diagnosis and treatment of relapsed SCC.

Background: Surgical ciliated cysts (SCC) of the maxilla appear as a delayed complication after surgery in the maxillary sinus, midface osteotomies, traumatic tooth extraction, and maxillary fractures. They are defined as a lytic lesion with entrapment of the pseudostratified columnar epithelium.Report of three cases: We present three patients in which after orthognathic surgery a slowly enlarging asymptomatic swelling mass was developed. On CT, all the cases presented lytic expansive lesions in the alveolar ridge. In the three cases, lesions were completely excised, and upon histological examination, ciliated pseudostratified columnar epithelium with goblet cells was found so they were diagnosed as SCC. An exhaustive review of the medical literature was conducted. The PubMed database was searched for PubMed Central (PMC). 44 references were found, reporting 1555 cases: 11 series and 33 case reports, being the largest series from the Asian countries. The mean age was 46.5 years, and more frequently described in male patients. The most frequent form of presentation was as unilateral unilocular cysts in the posterior maxilla. They were described most frequently after a Caldwell-Luc approach. The average latency time was of 19.9 years.Conclusion: SCC is a rare complication after orthognathic surgery, but large series have been published, so maybe it could be interesting to include these cysts in the next Edition of the World Health Organization Classification of the Head and Neck Tumors: Odontogenic and Maxillofacial Bone Tumors, making clear the difference between SCC and mucoceles to avoid future confusions.