Maxillary Myxoma: Surgical Treatment and Reconstruction with Buccal Fat Pad Flap: A Case Report

Abstract

Myxoma is a benign tumor that arises from mesenchymal tissue and is found less commonly in the bone than in soft tissue. The majority of bony myxomas occur in the jaws. When compared with other odontogenic tumors, myxoma of the jaws is a rare entity. Numerous types of treatment have been used for these tumors including simple curettage, enucleation, curettage with peripheral ostectomy, and en bloc resection with or without immediate reconstruction. The buccal fat pad (BFP) is a lobulated mass of fatty tissue in the oromaxillofacial region, which has long been a source of grafts in facial augmentation. A case of an odontogenic myxoma in the left maxillary molar area of a 34-year-old female that was treated by curettage and peripheral ostectomy is presented. The surgical defect was successfully repaired with a pedicled BFP flap. Citation Öğütcen-Toller M, Şener I, Kasap V, Çakir-Özkan N. Maxillary Myxoma: Surgical Treatment and Reconstruction with Buccal Fat Pad Flap: A Case Report. J Contemp Dent Pract 2006 February;(7)1:107-116.

Odontogenic myxoma – A case series and review of the surgical management

“…In our experience, small bony defects (smaller than 5 cm) can be reconstructed using buccal fatpad (maxilla), (Ogutcen-Toller et al, 2006), or using corticocancellous iliac crest bone graft (Demas and Sotereanos, 1988). Larger defects (more than 5 cm) usually require primary prosthetic reconstruction (obturator) (Chiodo et al, 1997) followed by a final obturator.…”

“…Due to the varied treatment possibilities in the past and current literature (Ghosh et al, 1973;Hendler et al, 1979;Chiodo et al, 1997;Ogutcen-Toller et al, 2006), it is the policy of our department that the treatment protocol for OMs resembles that of ameloblastoma, solid type, especially when locally aggressive behaviour is encountered which includes, cortical bone perforation and major tumour expansion and infiltration in a short period of time (weeks to months). A radical primary resection of the tumour with maximal preservation of surrounding anatomic structures is necessary (healthy anatomical borders of 0.5e1 cm beyond the tumours radiographic borders).…”

“…The treatment options can include curettage with peripheral ostectomy, segmental resection up to radical resections for the more aggressive lesions (Ghosh et al, 1973;Chiodo et al, 1997;Ogutcen-Toller et al, 2006). Ghosh et al (1973) reported a 50-year follow up of 10 cases of OMs, nine were treated by resection and one case was treated conservatively by local excision.…”

Prognostic Evaluation of Preserving Palatal Mucosa After Resection of Maxillary Myxoma

“…5 Treatment of odontogenic maxillary myxomas varies from enucleation and local excision to radical resection. 18 Despite the benign nature of these lesions, they tend to recur because of bone infiltration and lack of encapsulation. 14,22 Recurrence is directly related to the type of therapy.…”

Odontogenic myxoma in a 52-year-old woman

“…Reconstruction of bony defects less than 5 cm can be done with buccal fat pad7 in maxilla or using corticocancellous iliac crest bone graft in case of mandible 19. Larger defects (more than 5 cm) usually require primary prosthetic reconstruction followed by a final obturator 20.…”