The nasopalatine duct cyst (NPDC) was first ever described by Meyer in 1914.
Nasopalatine duct cyst is also termed as incisive canal cyst, arises from
embryogenic remnants of nasopalatine duct
Most of these cysts develop in the midline of anterior maxilla near the incisive
foramen.
It is one of the most common nonodontogenic cysts of the oral cavity
occurring in about 1% of the population
ETIOLOGY
The cyst originates from epithelial remnants from the nasopalatine duct.
The cells may be activated spontaneously during life or are eventually
stimulated by the irritating action of various agents (infection, etc.).
EPIDEMIOLOGY
Nasopalatine duct cysts are the most common non-odontogenic cyst found
within the anterior maxilla.
There is a 3 to 1 predilection for males; however, there is no significant
correlation between the size of these cysts and the patient’s gender.
CLINICAL FEATURES
Age predilection : fourth to sixth decades of life.
Gender predilection : common in men.
Patients may be asymptomatic, with the lesion being detected on routine
radiographs; however, many will present with one or more symptoms.
Complaints are often found to be associated with an infection of a previously
asymptomatic nasopalatine duct cysts and consist primarily of swelling,
drainage, and pain.
RADIOGRAPHIC FEATURES
Almost all nasopalatine cyst occurs within the incisive canal at any level
between nasal and oral cavity
Teardrop shaped and show a well demarcated slightly sclerotic border
Some cyst have an inverted pear shaped
Superimposition of the nasal spine classic heart shape
HISTOLOGICAL FEATURES
The cyst is lined by respiratory type of epithelium
The cyst is surrounded by fibrous capsule exhibiting a mild degree of chronic
inflammation
EVALUATION
Nasopalatine duct cysts present histologically with an epithelial-lined cyst
wall surrounded by fibrovascular connective tissue, oftentimes with
minor salivary glands as incidental findings.
Vitality testing must be performed on teeth associated with the lesion to
rule out an odontogenic source, such as a periapical cyst or granuloma.
Teeth associated with a nasopalatine duct cyst will test vital.
DIFFERENTIAL DIAGNOSIS
Any odontogenic cyst (lateral periodontal cyst and periapical
cyst/granuloma)
Enlarged incisive fossa
Central giant cell granuloma
TREATMENT
Nasopalatine duct cysts are best treated by surgical resection.
After removal, it is important to monitor patients both clinically and
radiographically to determine if the lesion has completely resolved.
Recurrence is rare
PROGNOSIS
Nasopalatine duct cysts have an excellent prognosis with rare recurrence.
The biopsy usually reveals adequate treatment (complete excision).