Mrad Mohamed A, Shah Mardan Qutaiba N M, Mahabbat Nehal A
King Faisal Specialist Hospital and Research Centre, Department of Surgery, Plastic and Reconstructive Surgery Section, Riyadh, Saudi Arabia.
King Faisal Specialist Hospital and Research Centre, Department of Surgery, Plastic and Reconstructive Surgery Section, Riyadh, Saudi Arabia.
Int J Surg Case Rep. 2020;77:766-768. doi: 10.1016/j.ijscr.2020.11.117. Epub 2020 Nov 25.
Implant-based genioplasty is a simple and safe but not complication-free cosmetic procedure. Patients are commonly briefed about anticipated complications and their management pre-operatively, but few unexpected complications may arise; and this case report is an example. This paper is the first to report a radicular cyst fistulating through chin implant pocket to the skin. Moreover, we present our prevention strategy and recommendations.
A 39-year-old-lady underwent a silicone implant-based genioplasty that was uneventful. Later, she developed a reddish nodule on the chin necessitating fistulectomy followed by a recurrence leading to explantation. It was not until the second recurrence that a fistulating radicular cyst was discovered and was treated with the help of a dentist.
Radicular cysts are benign, inflammatory cysts that arise in a background of dental trauma or caries. No link has been discovered yet between silicone implants and radicular cysts or fistulating cysts. Moreover, we propose that poor oral hygiene could be implicated in the development of these cysts. Dental panoramic X-ray has been used to diagnose radicular cysts, but its efficacy as a screening tool needs to be studied. Finally, the recurrence rate of radicular cysts is unknown.
In a patient with chin implant, radicular cysts could lead to a disastrous outcome. Through history and physical examination, a plastic surgeon should identify patients with poor oral hygiene and dental trauma prior to implant-based genioplasty to arrange for a dental panoramic X-ray. Patients known to have radicular cysts should not undergo an implant-based genioplasty.
植入式颏成形术是一种简单、安全但并非无并发症的美容手术。术前通常会向患者详细介绍预期的并发症及其处理方法，但仍可能出现一些意外并发症；本病例报告就是一个例子。本文首次报道了根尖囊肿通过颏部植入物腔隙破溃至皮肤。此外，我们还介绍了预防策略和建议。
一名39岁女性接受了硅胶植入式颏成形术，手术过程顺利。后来，她颏部出现一个红色结节，需要进行瘘管切除术，随后复发，导致植入物取出。直到第二次复发时，才发现一个破溃的根尖囊肿，并在一名牙医的帮助下进行了治疗。
根尖囊肿是在牙齿创伤或龋齿背景下发生的良性炎症性囊肿。尚未发现硅胶植入物与根尖囊肿或破溃囊肿之间存在关联。此外，我们认为口腔卫生不良可能与这些囊肿的发生有关。牙科全景X线已用于诊断根尖囊肿，但其作为筛查工具的有效性尚需研究。最后，根尖囊肿的复发率尚不清楚。
对于颏部植入物患者，根尖囊肿可能导致灾难性后果。整形外科医生在进行植入式颏成形术前，应通过病史和体格检查识别出口腔卫生不良和有牙齿创伤的患者，安排进行牙科全景X线检查。已知患有根尖囊肿的患者不应接受植入式颏成形术。
