An epithelial cyst is a rare and often late complication of long-term alloplastic implants, which has the potential to lead to further complications and harm to patients. We made a systematic review of papers published during the past 30 years about the mechanisms and clinical characteristics formation of epithelial cysts after repair of an orbital fracture by searching PubMed, Medline, and Web of Science to collect all related case reports and series published in the English language. We also made a retrospective review of casenotes of all patients diagnosed with orbital epithelial cysts in our department. We found 19 cases of epithelial cysts, including the four cases of our own, associated with alloplastic material, 12 of which were associated with silicone. There were 12 men and seven women aged from 26-71 years old. Orbital cysts developed 15 months-31 (median 8) years after implantation. Histological analysis confirmed that the cysts were all epithelial cysts lined with squamous or respiratory (or both) cells, and differing degrees of chronic inflammation. Epithelial cysts after implantation of alloplastic material may present with various symptoms several years after repair of orbital fractures, and their formation probably results from the synergistic effects of both ectopic cells and chronic inflammation. The implant itself may be a trigger, and the cysts did not seem to be limited to one specific type of implant.
Keywords: Alloplastic implant; Complication; Epithelial cyst; Orbital fracture.
Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.