Treatment of a large maxillary cyst with marsupialization (case report)

Alomar, Ahmed; Elmorsy, Khairy

doi:10.15761/ohc.1000132

Cited by 5 publications

(5 citation statements)

References 9 publications

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“…Radical surgical excision with complete removal of the cystic capsule is the most important element for a predictable result [42]. Another potential risk when using marsupialization as a stand-alone treatment is the malignant transformation of the residual cystic membrane in time [43,44]. In our case, radical cystic excision was conducted half a year after marsupialization, with the addition of a titanium mesh reconstruction covering the mandibular fenestration, in order to prevent dehiscence with subsequent chronic orocystic fistula.…”

Section: Discussionmentioning

confidence: 97%

Minimally Invasive Two-Staged Surgery in the Treatment of Large Cystic Lesions of the Jaw

Irimia¹,

Moraru

Ciubotaru

et al. 2021

Healthcare

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Background: Cystic lesions of the jaw are commonly found in clinical practice. Large, expansive cysts raise challenges for the clinician from both diagnostic and surgical perspectives. The aim of our work is to present a combined, two-staged surgical approach in histologically confirmed non-aggressive cystic lesions of the jaw. Methods and Results: We report the case of an extensive mandibular cyst, associating a high risk of bone fracture, that is treated in the initial stage by cystic decompression through marsupialization with concomitant histological diagnostic confirmation, followed in the second stage by radical excision and mandibular reconstruction with titanium mesh, with the purpose of prevention for oro-cystic chronic fistula formation. Conclusions: Large odontogenic mandibular cysts imply a meticulously conducted assessment and treatment. Marsupialization should be taken into consideration for the treatment of large cystic lesions, followed by secondary enucleation, with minimal risks for the patient. The soft tissue healing process can be optimized with the use of titanium meshes, as an alternative for other reconstructive techniques, in the management of large cystic lesions.

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Section: Discussionmentioning

confidence: 97%

Minimally Invasive Two-Staged Surgery in the Treatment of Large Cystic Lesions of the Jaw

Irimia¹,

Moraru

Ciubotaru

et al. 2021

Healthcare

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“…This surgical step is a decompression stage to decrease intracystic and internal hydrostatic pressure. 29,30 Decompression eliminates tension in the surrounding bone surface that inhibits proliferation and differentiation of the osteogenic precursor, so this procedure induces a signaling pathway that promotes osteogenesis. 31 The goals of marsupialization are to decrease the size of the lesion, promote bone growth, and convert cystic epithelium to normal oral epithelium.…”

Section: Discussionmentioning

confidence: 99%

The diagnostic challenges and two-step surgical approach to an infected dentigerous cyst resembling a unicystic ameloblastoma: A case report

Suryabharata,

Rizqiawan,

Mulyawan

et al. 2023

Dent. J.

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Background: A dentigerous cyst is the second-most frequently observed odontogenic cyst, and an ameloblastoma is one of the most frequently observed odontogenic tumors. Both are mostly associated with an impacted mandibular third molar and have similar characteristics. Diagnostic difficulties often result in misdiagnosis and remain a challenge to overcome. Comprehensive clinical, radiographic, and histopathological views are essential to correctly diagnose the problem and formulate the most suitable treatment plan. Purpose: This case report aims to present a thorough approach to the diagnostic and surgical procedures involved in treating a dentigerous cyst that resembles an ameloblastoma by using marsupialization followed by enucleation. Case: This article presents the case report of a 27-year-old male patient with an infected dentigerous cyst resembling a unicystic ameloblastoma associated with a totally impacted lower mandibular left third molar. The patient had a history of swelling, pain, and pus drainage in the retromolar area. Symptoms subsided after antibiotic and analgesic prescriptions, but the lesion remained and was slowly progressing. The diagnostic approach began with a fine-needle aspiration biopsy, and the result confirmed a benign cystic lesion that was suspected to be an odontogenic tumor. Then an incisional biopsy was conducted under local anesthesia, diagnosing an infected dentigerous cyst. Case Management: Marsupialization and decompression using an obturator was preferred, followed by enucleation. Nine months later, a radiographic examination revealed satisfactory bone regeneration without recurrence. Conclusion: An incisional biopsy plays a vital role in establishing a definitive diagnosis. Marsupialization followed by enucleation offers an excellent combination of treatments achieving complete cyst removal, anatomical structure preservation, and bone regeneration with minimal complications.

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“…Later on, Kruger modified the technique to an acrylic button traversed by metal or plastic tube to maintain opening the wound and facilitate irrigation and drainage of cystic cavity [11] . Decompression is intent to relieve osmotic pressure produced by cystic fluid into surrounding bony walls allowing diminishing of the cyst, deposition of new bone, minimizing risk of pathological fracture, preserving adjacent vital structures and allowing eruption of involved teeth [11,12] . Decompression has not been entrusted to treat OKC as it was thought that the remnants of pathological tissues will keep proliferating.…”

Section: Introductionmentioning

confidence: 99%

Decompression Effect on Morphological and Histological Changes of Odontogenic Keratocyst

Elhawaty

2023

OMX

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Odontogenic Keratocyst (OKC) is a benign cystic lesion characterized with aggressive behavior and relatively high recurrence rate. Most of the current suggested therapeutic surgical approaches are jeopardizing vital structures and integrity of the mandible ending with unjustified resections. We aim to evaluate the validity of decompression as a curative treatment for OKC Patients and Methods: Prospective case series studies of 10 patients were diagnosed with OKC through clinical, radiographical and pathological examination. All patients were treated with decompression. Histopathological features and volumetric changes were evaluated during follow up periods at 3, 6 and 9 months postoperatively. Results: All OKC lesions showed positive response to decompression. Age ranged from 8 to 45 with mean age of 25.9 years. Lesions' size ranged from 47478.6 mm3 to 4615.52 mm3 with mean size of 20949.5 mm3. Reduction rate percentage in a period of 9 months follow up was 80.36% (P-value=0.002) Conclusion: Decompression is a noninvasive preliminary curative approach for treating OKC.

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Treatment of a large maxillary cyst with marsupialization (case report)

Cited by 5 publications

References 9 publications

Minimally Invasive Two-Staged Surgery in the Treatment of Large Cystic Lesions of the Jaw

Minimally Invasive Two-Staged Surgery in the Treatment of Large Cystic Lesions of the Jaw

The diagnostic challenges and two-step surgical approach to an infected dentigerous cyst resembling a unicystic ameloblastoma: A case report

Decompression Effect on Morphological and Histological Changes of Odontogenic Keratocyst

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