Incisive Canal Cyst (Nasopalatine Duct Cyst, NPDC)

Incisive canal cyst also known as nasopalatine duct cysts (NPDC), is a developmental cyst arising from the epithelial remnants of nasopalatine duct, a duct connecting the nasal cavity with anterior maxilla in fetal life. It is considered the most common non-odontogenic cyst of jaw bone.

Often it presents in 4th to 6th decades, with slight male predilection. Patients may be asymptomatic, or can have pain, discharge and swelling often due to infection.

Incisive canal cyst is often >15mm in size, whereas the normal finding of incisive foramen is not expected to cross 6mm in diameter.  These cyst is seen superior to the roots of the maxillary incisors and usually doesn't result in any root resorption, but can sometimes result in displacement of the incisor roots.


Below are MRI images of incidentally detected Incisive canal cyst in a 50 year old male patient. MRI was done for evaluation of headache. T2 weighted sagittal, coronal and axial images shows a hyperintense cystic lesion in the anterior maxilla with mild displacement of the roots of maxillary incisors. Cyst measured 13.3mm in width.

Cyst was isointense to muscle in T1 WI (not shown), and hyperintense in T2 FLAIR images (not shown).

See another case of Incisive Canal Cyst : CT images HERE.

Incisive Canal Cyst (Nasopalatine Duct Cyst)

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Patient is a 55yr old male, did CT for nasal obstruction, to look for sinusitis. Incidental cyst found in anterior maxilla between roots of central incisors. Multiple periapical lucencies are also seen in the maxillary molars of both sides.

 

Incisive Canal Cyst (Nasopalatine Duct Cyst)

A nasopalatine duct cyst (incisive canal cyst) is a nonodontogenic developmental cyst or fissural cyst arising in the nasopalatine duct near the anterior palatine papilla. It is the most common nonodontogenic cyst. The cysts probably arise from epithelial remnants in the incisive canal. They can occur at any age but are most frequently found in the fourth and sixth decades of life, with no sex predilection. These cysts are usually asymptomatic, but some patients note swelling in the palate, especially when the cyst is primarily in the incisive papilla. Alternatively, the anterior maxilla can be remodeled forward, elevating the columella of the nose.

It may be difficult on imaging to differentiate between an enlarged incisive fossa and an incisive canal cyst. The incisive canal cyst is always located at or close to the midline and usually is round or ovoid, although it may be heart-shaped. A condensed rim of cortical bone is often seen along the periphery, and the lesion may displace the roots of the central incisor teeth.

Reference : Head and Neck Imaging, by Peter.M.Som, 4th Edition.