J Korean Assoc Oral Maxillofac Surg.  2010 Aug;36(4):286-290. 10.5125/jkaoms.2010.36.4.286.

Treatment of huge mandibular cyst with enucleation after decompression under local anesthesia

• Cha YH
• Kim HJ
• Cha IH
• Nam W

• KMID: 1457781
• DOI: http://doi.org/10.5125/jkaoms.2010.36.4.286

Abstract

Various treatment methods for huge cystic lesion of the jaw exist, such as, resection of the involved bone, enucleation and decompression. Among these methods, enucleation after decompression is a conservative technique that decreases the size of the cystic cavity and reduces the risk of intrabony defects, which could be induced by primary enucleation. In addition, it can save the adjacent anatomic structures. In these cases, the decompression combined with partial enucleation, which was performed before complete cyst enucleation was performed on huge cystic lesions of the mandible. During the process, a decrease in the size of the lesion and the growth of normal oral tissues was observed. The size of the lesion decreased until the time of complete enucleation, and surgery could be performed under local anesthesia. No damage to inferior alveolar nerve was observed. We report these cases with a review of the relevant literature.

Keyword

Decompression; Mandible; Cysts

MeSH Terms

Anesthesia, Local
Decompression
Jaw
Mandible
Mandibular Nerve

Figure

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  Fig. 1. Panoramic X-rays of case 1. A. Preoperative panoramic X-ray. Huge cystic lesion is observed on the symphysis and left body of mandible. B. Post operative panoramic X-ray. After the decompression and subsequent enucleation, the cavity size of the lesion is decreased. C. Nine months follow up panoramic X-ray. Almost ossification is observed.

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  Fig. 2. Panoramic X-rays of case 2. A. Preoperative panoramic X-ray. Scalloped huge cystic lesion is observed on the symphysis and right body of mandible. B. Post operative panoramic X-ray. After the decompression and subsequent enucleation, the cavity size of the lesion is decreased. C. Recurred odontogenic keratocyst is observed on the apex of right canine of mandible. D. One year follow up panoramic X-ray. Almost ossification is observed.

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  Fig. 3. Panoramic X-rays of case 3. A. Preoperative panoramic X-ray. Huge radioluscent lesion is observed on the right body and angle of mandible. B. Post operative panoramic X-ray. After the decompression and subsequent enucleation with extraction of root rests, the lesion is almost healed.

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  Fig. 4. Panoramic X-rays of case 4. A. Preoperative panoramic X-ray. Huge radioluscent lesion is observed on the right body and angle of mandible. B. Post operative panoramic X-ray. After the decompression and subsequent enucleation with extraction of #48 and endodontic treatment on #46, 47, the lesion is almost healed with proper ossification.

Reference

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