Endoscopic resection of maxillary sinus keratocystic odontogenic tumors

Management of Odontogenic Cysts by Endonasal Endoscopic Techniques: A Systematic Review and Case Series

“…Studies included in the systematic review are summarized in Table 2. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] In the 16 included studies, a total of 45 patients were treated for different odontogenic cysts by using a variety of endonasal endoscopic techniques. No recurrences were reported, and the weighted mean follow-up was 29.2 months.…”

“…[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] There were no reported recurrences when using these approaches, including 12 cases of KCOT. 12,[14][15][16][17]19,20,25 No major complications were associated with these procedures, and minor complications were limited to 3 of 52 cases. 13 In total, analysis of these data indicated that an endonasal endoscopic approach to odontogenic cysts of the maxilla is a feasible and effective treatment strategy, and is without undue morbidity.…”

“…Even in cases of locally aggressive KCOT, the recurrence rate seemed to be comparable with open approaches, although follow-up remains limited. 3,31 A multitude of endoscopic techniques have been used in the treatment of odontogenic cysts, including maxillary antrostomy, 17,[19][20][21]23,24,26 "mega-antrostomy," 15 modified medial maxillectomy, 12,14,16,22 and medial maxillary sinus wall transposition. 13 All of these techniques have been used effectively, although, in reviewing patients from our institution, a wide maxillary antrostomy allows for effective decompression and marsupialization of the lesion (Fig.…”

“…Adjunctive use of the Carnoy or the modified Carnoy solution has been applied to remnant epithelia in the treatment KCOT in both open and endoscopic techniques. 3,12,33 The Carnoy solution consists of 100% ethanol, chloroform, glacial acetic acid, and ferric chloride. 33 Compounding with chloroform, however, was banned in 1992 by the U.S. Food and Drug Administration due to carcinogenic effects, and, therefore, modified solutions without chloroform have been used.…”

“…[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] The presumed benefit of an endoscopic approach is avoidance of morbidity associated with open, transoral approaches, including alterations in dentition, oroantral fistula, chronic rhinosi-nusitis, and extended recovery time. 12,15 Open approaches can also result in a more-complex reconstruction than an endonasal technique. 15 Differentiation of odontogenic cyst histopathology before surgery can be difficult, in which case, endoscopic management offers a potentially diagnostic and therapeutic approach.…”