Endoscopic-assisted Enucleation of Radicular Cysts — A Case Report
Journal name: The Malaysian Journal of Medical Sciences
Original article title: Endoscopic-assisted Enucleation of Radicular Cysts — A Case Report
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:
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Abdullah Kahairi, Shamim Ahmed Khan, Ahmad Amirozi
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: Endoscopic-assisted Enucleation of Radicular Cysts — A Case Report
Year: 2010
Copyright (license): CC BY 4.0
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Summary of article contents:
Introduction
Benign jaw cysts, particularly radicular cysts, are common pathologies that typically occur at the apices of non-vital teeth and result from the stimulation of the odontogenic epithelium due to necrotic pulp. The standard management options for these cysts include enucleation, marsupialisation, curettage, decompression, and even resection, depending on the size and extent of the cyst. Enucleation is preferred due to the ability to send the entire specimen for histological evaluation, thereby avoiding the risk of missing more serious pathologies. However, when faced with large cystic lesions in the maxilla, technical difficulties in achieving access and visibility can hinder effective enucleation, sometimes necessitating aggressive approaches.
Enhanced Visualization through Endoscopic Assistance
The incorporation of endoscopic assistance during surgical procedures such as enucleation offers significant advantages, particularly for large jaw cysts. In the reported case of a 26-year-old female patient with a large radicular cyst displacing the floor of the maxillary sinus, the surgical team initially approached enucleation through a sublabial incision. However, complications arose due to limited visibility while working towards the superior aspects of the cyst. By integrating a rigid endoscope, the surgical team was able to navigate challenging corners and obtain superior illumination and magnification, improving the precision of the cyst removal while minimizing tissue damage. This method not only enhanced the surgical outcome but also facilitated a more conservative approach, resulting in reduced postoperative morbidity.
Conclusion
The findings from this case highlight the efficacy of endoscopic-assisted enucleation for managing large benign jaw cysts, which provides a viable alternative to traditional surgical techniques that may involve extensive tissue damage and increased recovery time. The ability to perform enucleation with endoscopic assistance allows for enhanced visualization, resulting in a safer and more effective procedure. Such an approach emphasizes the importance of collaboration between oral-maxillofacial and otorhinolaryngology teams when addressing complex cases of jaw cysts to maximize patient outcomes and minimize complications. Ultimately, this technique showcases a promising avenue for the surgical management of benign jaw cysts, particularly in cases that present significant anatomical challenges.
FAQ section (important questions/answers):
What is the standard management for benign jaw cysts?
The standard management includes enucleation, marsupialization, curettage, and decompression. Enucleation allows for complete microscopic evaluation, which is crucial to rule out more serious conditions like squamous cell carcinoma.
What are radicular cysts and how do they form?
Radicular cysts are the most common inflammatory jaw cysts, occurring at the apex of non-vital teeth. They arise due to the stimulation of odontogenic epithelium by necrotic pulp and contents from the root canal.
How does the Caldwell Luc approach assist in cyst removal?
The Caldwell Luc approach, enhanced by endoscopic assistance, addresses limited visibility when enucleating large cysts. It allows for better illumination and visualization of difficult areas without extensive tissue damage.
What are the advantages of an endoscopic-assisted approach to enucleation?
Endoscopic-assisted enucleation minimizes tissue damage, reduces blood loss, and allows for superior visualization during the procedure. It enhances surgical precision and can be performed with a less invasive incision.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Endoscopic-assisted Enucleation of Radicular Cysts — A Case Report”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Incision:
Incision refers to the surgical cut made in the tissue during a procedure. In the context of jaw cyst management, a sublabial incision was used for access. The choice of incision impacts visibility, tissue trauma, and subsequent healing, making it a critical element in successful surgical outcomes.
2) Wall:
Wall denotes the anatomical boundaries of the cystic lesion or any surrounding structures. In the reported case, the cyst exhibited a double wall appearance on CT scans, indicating its volume and internal structure. Understanding the wall's characteristics aids in surgical planning and predicting potential complications during enucleation.
3) Surrounding:
Surrounding pertains to the structures adjacent to the cyst, such as vital anatomical elements like the maxillary sinus and nerves. Preservation of surrounding tissues during enucleation is crucial to minimize complications and ensure recovery. The mention of surrounding tissues reflects the intricate nature of performing surgery in this area.
4) Arrow:
Arrow signifies the indication in imaging studies (like CT scans) that points out relevant anatomical structures or lesions. In the manuscript, arrows in the figures highlight the cyst's location, displacing the maxillary sinus floor. This visual aid is essential for clarity in surgical planning and communication among medical professionals.
5) Swelling:
Swelling is a clinical sign often indicating an underlying pathological process, like inflammation or the presence of a cyst. In the case report, facial swelling was associated with the radicular cyst, providing insight into the condition's severity. Recognizing swelling patterns helps healthcare providers assess and diagnose oral pathologies effectively.
6) Nostril:
Nostril refers to the nasal openings, which were assessed during examination for signs such as bulging or abnormality due to the cyst. Observations connected to the nostrils may reveal the extent of nasal involvement by cystic disease, offering a comprehensive view of how the cyst affects surrounding structures in the facial region.
7) Field:
Field relates to the surgical area where operations are performed. In endoscopic surgery, a clear and well-illuminated field is crucial for visibility and accuracy. The advancement of endoscopy improves the surgical field, assisting the surgeon in performing tasks with minimal invasiveness and optimal precision during enucleation of the cyst.
8) Pain (Paiṇ):
Pain is an indication of inflammation or irritation often associated with conditions like cysts. In the case report, the patient experienced pain alongside swelling, which contributed to diagnosing the radicular cyst. Understanding the pain profile helps clinicians gauge the condition’s severity and determine appropriate interventions and pain management strategies.
9) Hand:
Hand refers to the surgeon's operational control during surgery, which is crucial when navigating complex anatomical regions. In the described technique, one hand held the endoscope while the other performed enucleation, demonstrating the coordination necessary in minimally invasive approaches. Efficient hand motion is vital for precise surgical outcomes during cyst removal.
10) Allergy:
Allergy in the context of this report pertains to the initial misdiagnosis of the patient's symptoms, which later turned out to be caused by a radicular cyst rather than allergic rhinitis. Recognizing allergens is significant for differentiating between conditions that may present similarly, thus enhancing the accuracy of clinical diagnosis and treatment planning.
11) Thomas:
Thomas likely refers to an author or a study cited within the references, emphasizing collaboration in developing medical knowledge. The mention of author names such as 'Thomas' in the context of the report bolsters the scientific discourse surrounding the techniques and complications associated with jaw cyst management, enriching the overall scholarly conversation in this space.
12) Blood:
Blood is indicative of surgical trauma or complications during surgery. In the case reported, minimizing blood loss occurred with the endoscopic technique, underscoring its advantage in achieving better outcomes through a more controlled surgical approach. Blood management remains a critical aspect of surgical procedures, influencing postoperative recovery and overall patient safety.
13) Pur (Pūr):
Poor refers to inadequate conditions, such as visibility or illumination during surgery, which complicates the operative process. In the reported case, poor visibility necessitated the use of endoscopic assistance, showcasing the importance of addressing surgical limitations through innovative solutions for enhanced procedural success and patient safety.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Endoscopic-assisted Enucleation of Radicular Cysts — A Case Report’. Further sources in the context of Science might help you critically compare this page with similair documents:
Medical science, Surgical incision, Complete removal, CT scan, Nasal cavity, Oral cavity, Visual examination, Nasal blockage, Local anaesthesia, Maxillary Sinus, General anesthesia, Histopathological examination, Surgical approach, Histological evaluation, Important structures, Enucleation, Computed tomography, Anterior rhinoscopy, Postnasal drip, Facial pain, Postoperative period, Nasal spray, Benign lesion, Tissue damage, General anaesthesia, Middle third, Odontogenic cyst, Radicular cyst, Excision of the cyst, Root canal system, Combined approach, Surgical field, Cranial nerve, Frontal Headache, Surgical Team, Endoscopic removal, Nasal septum, Regional lymph nodes, Postoperative morbidity, Maxillary sinus floor, Odontogenic epithelium, Soft tissue mass.