Use of decompression tubes in the management of excessively large odontogenic keratocyst

Abstract

Odontogenic keratocyst (OKC) is a unique cyst because of its locally aggressive behaviour, high recurrence rate and characteristic histological appearance. A radical surgical approach is commonly advocated with morbid and disfiguring results. This approach also presents several reconstructive obstacles especially in anterior mandible. In this case report the authors present a 25-year-old male patient with a large OKC and treatment with decompression followed by enucleation, and chemical cauterisation. This approach though demanding prolonged treatment time and postoperative follow-up decreases the morbidity to a great extent in a young individual. At the same time, it allows an opportunity for the maxillofacial surgeon to preserve the natural dentition, maintain function and safeguard cosmesis. In our case, the authors effectively achieved all the aforementioned objectives. At the same time a radical option of treatment is still left in the armoury if required at a later date.

Abordagem clínica e terapêutica sobre o Tumor Odontogênico Ceratocístico: uma revisão abrangente da literatura

“…1. 38 casos -Somente aumento de volume 17,20,21,[23][24][25][26][28][29][30]35,[39][40][41][46][47][48]52,53,56,59,63,64,67,[70][71][72]75,81,89,92 ; 2. Aumento de volume associado a:…”

“…53 casos -Não reportado [10][11][12][14][15][16]18,25,27,30,33,35,36,41,46,50,51,55,56,[58][59][60][61]63,64,[66][67][68][71][72][73]75,76,79,81,[82][83][84][87][88][89]91 ; 2. 20 casos -CO 8,9,13,17,19,22,28,29,31,37,39,…”

“…Tais dados confirmam aqueles encontrados por FINKELSTEIN et al (2013) 96 . Além disso, foi relatada fenestração óssea 8,17,19,22,30 , envolvimento da cavidade nasal 10,30,64 , associação a elementos dentários 12,14,15,18,27,28,[31][32][33]39,40,43,54,55,58,62,66,67,82,83,85 dentes impactados 35,61,64 , e fratura mandibular 87 associada à lesão. Houve, também, casos onde não houve envolvimento ósseo 16,26,57,59,65 .…”

Comparison of wall removal type versus wall retaining type of decompression for treating large mandibular odontogenic cysts

“…In the first operation, the bone on the surface of the cyst is opened, and then, a small amount of wall tissue near the open window is cut to visualize its pathology. After surgery, the hole of the cyst is filled with a stent to prevent open window occlusion (Garde, Kulkarni, Dadhe, & Deshmukh, ; Swantek, Reyes, Grannum, & Ogle, ). After a period of window decompression, the volume of the cyst gradually reduces, and bone deposition gradually occurs in that part of the cyst.…”

“…After surgery, the hole of the cyst is filled with a stent to prevent open window occlusion (Garde, Kulkarni, Dadhe, & Deshmukh, 2012;Swantek, Reyes, Grannum, & Ogle, 2012). After a period of window decompression, the volume of the cyst gradually reduces, and bone deposition gradually occurs in that part of the cyst.…”