Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
J Endod. 2011 Sep;37(9):1320-6. doi: 10.1016/j.joen.2011.05.041. Epub 2011 Jul 20.
The nasopalatine duct cyst (NPDC) is the most frequent nonodontogenic cyst of the jaws and can be misinterpreted as an apical lesion of endodontic origin.
In the first case, a 17-year-old male patient was referred because of a pressure sensation in the anterior maxilla. The teeth #7, #8, #10, and #11 responded to cold sensitivity testing, and on tooth #9 an endodontic treatment had been performed 3 years ago. Only periapical radiographs had been taken, and a radicular cyst was suspected. In the second case, a 42-year-old man reported inconvenience wearing his upper removable partial denture. Suspecting a jaw cyst in the anterior maxilla, the general dental practitioner referred the patient.
Limited cone-beam computed tomography scans visualized the expansion of the cysts and the involvement of the neighboring structures in both cases. In both patients, the NPDCs were treated first by marsupialization in local anesthesia and second with cystectomy in general anesthesia with reconstruction of the defect areas with bone gained from the iliac crest. The final diagnosis was achieved by histopathological examination.
If not diagnosed early, the NPDC can expand through the palatal and/or buccal cortical wall and also into the nasal cavity. The more expansive the NPDC is becoming, the more complex the final diagnosis is and the subsequent surgical therapy.
鼻腭管囊肿（NPDC）是颌骨最常见的非牙源性囊肿，可被误诊为牙髓来源的根尖病变。
在第一个病例中，一名 17 岁男性因上颌前部有压迫感而就诊。牙齿 #7、#8、#10 和 #11 对冷敏感测试有反应，而牙齿 #9 曾在 3 年前进行过牙髓治疗。仅拍摄了根尖片，怀疑为根尖囊肿。在第二个病例中，一名 42 岁男性报告佩戴上颌可摘局部义齿不方便。由于怀疑上颌前部有颌骨囊肿，全科医生将患者转介。
在两个病例中，有限的锥形束 CT 扫描显示了囊肿的扩张以及邻近结构的受累。在这两个患者中，NPDC 均先在局部麻醉下进行袋形手术治疗，然后在全身麻醉下进行囊肿切除术，并使用从髂嵴获得的骨重建缺损区域。最终诊断通过组织病理学检查确定。
如果不能早期诊断，NPDC 可通过腭侧和/或颊侧皮质骨壁扩张，并进入鼻腔。NPDC 越扩张，最终诊断越复杂，后续的手术治疗也越复杂。
