Nakashima Torahiko, Uchi Ryutaro, Uryu Hideoki
Otolaryngology - Head and Neck Surgery, National Hospital Organization (NHO) Kyushu Medical Center, Fukuoka, JPN.
Otorhinolaryngology, Yamaguchi Red Cross Hospital, Yamaguchi, JPN.
Cureus. 2025 Jun 21;17(6):e86513. doi: 10.7759/cureus.86513. eCollection 2025 Jun.
Two distinct cases of giant epidermoid cysts in rare head and neck anatomical locations - one in the sublingual space and the other in the infratemporal fossa - are reported, highlighting the variability in presentation, imaging characteristics, and surgical management. Transoral excision of the cyst was selected for case 1 to minimize cosmetic concerns. For case 2, given the benign nature of the lesion and the patient's preference for a less invasive procedure, endoscopic marsupialization via a transnasal-transmaxillary approach was chosen. This method relieved symptoms, minimized surgical risks, and preserved quality of life, with no recurrence noted after three years. These cases underscore the importance of individualized treatment strategies for giant epidermoid cysts. While complete surgical excision remains the gold standard, minimally invasive options such as marsupialization may be appropriate in selected patients, especially when considering factors such as age, comorbidities, symptoms, and cosmetic outcomes.
报告了两例罕见头颈部解剖部位的巨大表皮样囊肿——一例位于舌下间隙,另一例位于颞下窝,突出了临床表现、影像学特征和手术治疗的变异性。病例1选择经口切除囊肿以尽量减少美容问题。对于病例2,鉴于病变的良性性质以及患者对侵入性较小手术的偏好,选择了经鼻 - 上颌窦入路的内镜袋形缝合术。该方法缓解了症状,将手术风险降至最低,并保留了生活质量,三年后未见复发。这些病例强调了巨大表皮样囊肿个体化治疗策略的重要性。虽然完整的手术切除仍然是金标准,但对于选定的患者,袋形缝合术等微创选择可能是合适的,特别是在考虑年龄、合并症、症状和美容效果等因素时。