Irimia Andreea, Moraru Liliana, Ciubotaru Diana Alina, Caruntu Constantin, Farcasiu Alexandru-Titus, Caruntu Ana
Department of Oral and Maxillofacial Surgery, "Carol Davila" Central Military Emergency Hospital, 010825 Bucharest, Romania.
Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, "Titu Maiorescu" University, 031593 Bucharest, Romania.
Healthcare (Basel). 2021 Nov 10;9(11):1531. doi: 10.3390/healthcare9111531.
Cystic lesions of the jaw are commonly found in clinical practice. Large, expansive cysts raise challenges for the clinician from both diagnostic and surgical perspectives. The aim of our work is to present a combined, two-staged surgical approach in histologically confirmed non-aggressive cystic lesions of the jaw.
We report the case of an extensive mandibular cyst, associating a high risk of bone fracture, that is treated in the initial stage by cystic decompression through marsupialization with concomitant histological diagnostic confirmation, followed in the second stage by radical excision and mandibular reconstruction with titanium mesh, with the purpose of prevention for oro-cystic chronic fistula formation.
Large odontogenic mandibular cysts imply a meticulously conducted assessment and treatment. Marsupialization should be taken into consideration for the treatment of large cystic lesions, followed by secondary enucleation, with minimal risks for the patient. The soft tissue healing process can be optimized with the use of titanium meshes, as an alternative for other reconstructive techniques, in the management of large cystic lesions.
颌骨囊性病变在临床实践中较为常见。大型、扩展性囊肿从诊断和手术角度给临床医生带来了挑战。我们工作的目的是介绍一种针对组织学确诊的非侵袭性颌骨囊性病变的联合两阶段手术方法。
我们报告了一例广泛的下颌囊肿病例,该囊肿伴有较高的骨折风险,在第一阶段通过袋形缝合术进行囊肿减压,同时进行组织学诊断确认,第二阶段进行根治性切除并用钛网进行下颌骨重建,目的是预防口腔 - 囊肿慢性瘘管形成。
大型牙源性下颌囊肿需要进行细致的评估和治疗。对于大型囊性病变的治疗应考虑袋形缝合术,随后进行二期摘除,对患者风险最小。在大型囊性病变的管理中,使用钛网作为其他重建技术的替代方法可以优化软组织愈合过程。