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Purpose: This study describes the surgical outcome of pediatric primary spinal arachnoid cysts (SACs) presenting with compressive myelopathy and gives an update on the classification and management of these rare lesions. Methods: We performed a single-center retrospective analysis of pediatric patients operated for primary spinal arachnoid cysts. The clinical and radiologic profiles and surgical outcomes of these children were analyzed. Subgroup analysis was done in the laminoplasty vs laminectomy groups to see for the development of spinal deformity. Results: There were 10 males and seven females with a mean age of 10.4 years (range:6–14 years). The cysts extended to an average of 5.2 levels (range:2–8). They were extradural in seven (41%) and intradural in 10 (59%). Six intradural and four extradural cysts underwent laminectomy (n = 10) while four intradural and three extradural cysts underwent laminoplasty (n = 7). Although three out of 10 cases in the laminectomy group and none in the laminoplasty group had post-operative spinal deformity, this result was not statistically significant (p = 0.110). There was a moderate negative correlation between post-operative cord occupancy ratio (COR) and post-operative McCormick grade (Pearson correlation coefficient = -0.453, p = 0.068), suggesting that higher CORs are associated with lower McCormick grades. Conclusion: Symptomatic pediatric primary spinal arachnoid cysts are safely and effectively managed by marsupialization or microsurgical excision. Considering the growing age group, laminoplasty rather than laminectomy should be the standard surgical procedure to prevent late postoperative spinal deformity. Clinically significant recurrences are rare in the setting of adequate cord expansion and restored subarachnoid CSF flow following surgery. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to evaluate the trabeculation increase of treated mandibular cysts. Material and method: The study included 26 female and 33 male patients (age mean: 38,4 years) with cysts larger than 3 cm in the posterior region of the mandible who were admitted to the same center. Two groups in treatment technique: marsupialization (n = 29) and enucleation (n = 30). Four groups in cyst types: dentigerous cyst (n = 21), keratocyst (n = 19), radicular cyst (n = 15) and residual cyst (n = 4). Cyst size was divided into two categories: smaller than 5.5 cm (n = 31) and larger than 5.5 cm (n = 28). Panoramic radiographs (PR) of the patients were analyzed at the beginning, 6. month and 12. month. Result: At the end of the treatment, there was no statistically significant difference in terms of Fractal Analysis (FA) between patients treated with marsupialization and enucleation, but considering that the cysts in the marsupialization group were larger in size, a faster increase in FA was observed in the marsupialization group. When the cysts were grouped according to their size, it was observed that healing tissues in cysts smaller than 5.5 cm reached normal FA values faster, while healing in the middle of cysts larger than 5.5 cm took more time. Conclusions: FA is a reproducible and reliable method. In large cysts, marsupialization results in a faster recovery, but FA values at the end of treatment are similar to the enucleation group. Cysts larger than 5.5 cm show a more rapid increase in Fractal Dimension (FD). The centre of the cysts is the area that heals the latest. Studies with larger sample sizes are needed to evaluate the difference in healing between cyst types. Clinical trial number: Clinical trial number: Not applicable [ABSTRACT FROM AUTHOR]

Purpose: Sinonasal mucoceles (SM) are benign, expansive neoformations which require surgical marsupialization to prevent severe complications. The present study reports the larger case history ever published: a 28-years expertise in the surgical management of SM. Methods: A retrospective study was conducted on patients surgically treated for SM at the Departments of Otorhinolaryngology of Varese and Pavia, between 1994 and 2022. Results: 398 patients were reported. An endoscopic endonasal marsupialization of SM was performed in 92,5% of cases. 7% of patients underwent a combined approach while 0,5% required an exclusive open surgery. The average follow-up after surgery was 10–60 months. SM overall recurrence was observed in 11,4% of cases. Conclusion: Endonasal endoscopic SM marsupialization is a feasible technique which allows the preservation of the anatomy and physiology avoiding the surgical invasiveness of the external approaches. The well-established surgical expertise in the endonasal endoscopy together with technological improvements widened the indication range of the exclusive endoscopic technique over the traditional open surgery. [ABSTRACT FROM AUTHOR]

Abstract Aim The aim of the study was to evaluate the trabeculation increase of treated mandibular cysts. Material and method The study included 26 female and 33 male patients (age mean: 38,4 years) with cysts larger than 3 cm in the posterior region of the mandible who were admitted to the same center. Two groups in treatment technique: marsupialization (n = 29) and enucleation (n = 30). Four groups in cyst types: dentigerous cyst (n = 21), keratocyst (n = 19), radicular cyst (n = 15) and residual cyst (n = 4). Cyst size was divided into two categories: smaller than 5.5 cm (n = 31) and larger than 5.5 cm (n = 28). Panoramic radiographs (PR) of the patients were analyzed at the beginning, 6. month and 12. month. Result At the end of the treatment, there was no statistically significant difference in terms of Fractal Analysis (FA) between patients treated with marsupialization and enucleation, but considering that the cysts in the marsupialization group were larger in size, a faster increase in FA was observed in the marsupialization group. When the cysts were grouped according to their size, it was observed that healing tissues in cysts smaller than 5.5 cm reached normal FA values faster, while healing in the middle of cysts larger than 5.5 cm took more time. Conclusions FA is a reproducible and reliable method. In large cysts, marsupialization results in a faster recovery, but FA values at the end of treatment are similar to the enucleation group. Cysts larger than 5.5 cm show a more rapid increase in Fractal Dimension (FD). The centre of the cysts is the area that heals the latest. Studies with larger sample sizes are needed to evaluate the difference in healing between cyst types. Clinical trial number Clinical trial number: Not applicable

Introduction: There is a paucity of studies evaluating the preservation and recovery vitality of teeth associated with cystic lesions in the jaws. The purpose of the present study was to evaluate whether the use of the marsupialization treatment method in the large cystic lesions of the jaws associated within involved teeth would save the pulp vitality. Materials and methods: It was a cohort study of patients treated at the Department of Oral and Maxillofacial Surgery from April 2019 to April 2023. Patients with primary cystic lesions associated teeth, with a cyst diameter of >3.4 cm, along with dental root resorption of less than half the root length, and treated by marsupialization were included. Patient age, gender, location, associated teeth, size, management, dental pulp vitality before and after marsupialization, and the duration of treatment were evaluated. Pulp vitality of involved teeth was assessed with electrical pulp tester. Predictor Variable: It was the treatment method. Main Outcome Variable(s): The primary outcome variable was the recovery or preservation of pulp vitality. Covariates: The study variables were demographic, clinical features of the cysts, clinical features of associated teeth, and treatment method. Analyses: Categorical data were presented in mean with standard deviation, and set the level of statistical significance at p < 0.05. Results: The sample included 73 patients with large cystic lesions; 47 (64.4%) were male and 26 (35.6%) were female. The age range was 9 to 68 years (mean ± standard deviation, 22.4 ± 4). The 73 patients had 305 teeth associated with large cystic lesions. Of these dentitions, 85.9% of teeth had normal pulp vitality and 14.1% were negative before marsupialization. Following marsupialization, preservation of pulp vitality was noted in 61.3% and 18.0% of teeth lost their vitality. Of those without normal dental pulp vitality, 70.9% of teeth recovered their vitality of which 46.5% had recovered their vitality 9 to 12 months following marsupialization. Conclusion: Marsupialization followed by second surgery maybe a treatment option for preserving and recovering the pulp vitality of teeth associated with large cystic jaw lesions. [ABSTRACT FROM AUTHOR]

We aim to report a case of residual cyst in an 11-year-old boy, which was treated by marsupialization as a conservative alternative to surgical enucleation. An 11-year-old boy reported to our department with a painless swelling of approximately 1.5x1 cm in size intraorally, both in the maxillary right buccal and palatal region for about 1 month. On fine needle aspiration, a yellow-coloured highly viscous fluid was observed which on histopathological examination revealed an infected cyst. This along with the clinical examination and history confirmed the diagnosis of a residual cyst. Marsupialization was chosen as a conservative treatment due to the size of the cyst and the age of the patient. Weekly follow-up and dressing change were carried out for 6 months which lead to a complete resolution of the cyst with continuous normal development of the occlusion. No adverse effects such as fever, infection, or pus discharge were seen at any time during treatment. We have been able to design a treatment protocol which has provided us with a nonsurgical solution for large cystic lesions in growing patients without adverse effects for the complete duration of treatment. Marsupialization should be considered as a treatment option for large residual cysts, especially in pediatric patients. [ABSTRACT FROM AUTHOR]

Abstract Background To investigate the radiological and demographic features, types, distribution, and treatment methods of dentigerous cysts (DC). Methods Panoramic radiographs and cone beam computed tomography (CBCT) images of patients diagnosed with DC based on biopsy results between January 2020 and December 2023 were examined. In patients from different age groups, the numbers, types and locations, and radiological features of DCs, associated changes in surrounding tissues, and treatment methods used were reviewed. Results Among 95 patients with DC (66 males, 29 females), sex and age distributions were comparable between those with a single cyst (n = 86) and those with two cysts (n = 9). Of 104 DCs, 44 were central, 38 were lateral, and 22 were circumferential. DC types were not significantly affected by sex, age group, or anatomical location. Circumferential DCs often caused displacement of the mandibular canal inferiorly. While enucleation was preferred for the treatment of central DCs, circumferential DCs were treated with marsupialization. Conclusions In this study, which is the first to evaluate the DC types on CBCT images, the central type was the most common. Circumferential DCs were mostly treated with marsupialization. CBCT imaging can assist in determining DC types, and may provide guidance for treatment planning.

Nasopalatine duct cyst, which is also known as incisive canal cyst, is the most common developmental cyst of the maxilla. It arises from the proliferation of the remnants of the nasopalatine duct stimulated by trauma or infection. In this article, the authors report a rare case of an extensive nasopalatine duct cyst in a 57-year-old Male associated with non-vital tooth. Clinical examination revealed facial asymmetry associated with swelling that is painful and tender. Correlating clinical and radiological findings, a diagnosis of nasopalatine duct cyst was formed, and the histopathological examination confirmed the diagnosis of nasopalatine duct cyst. This case highlights the importance of knowing that nasopalatine duct cyst can be associated with non-vital teeth, challenging the assumption that they are exclusively associated with vital teeth. [ABSTRACT FROM AUTHOR]

Key Clinical Message: A plunging ranula may present initially as an extensive vallecular cyst and correct diagnosis may be reached with the use of ultrasound, fluid aspiration for amylase detection, and MRI imaging. The ranula is a pseudocyst of the sublingual salivary gland and can be divided into two known subtypes. The simple ranula and plunging ranula. While the simple type can be found in the floor of the mouth, the plunging ranula usually pervades the mylohoid muscle and presents as a cervical swelling. The presented case should outline the difficulties in diagnostic and treatment of an uncommon expression of a mucocele above the mylohoid muscle without presenting either a cervical or an intraoral swelling, only extending towards the vallecula. We present a previously unreported clinical manifestation of a ranula of an 18‐year old male, which extends posteriorly, remaining confined in the supramylohyoid muscle space. The cystic lesion protrudes in the oropharynx, and clinically appears as an extensive vallecular cyst. On magnetic resonance imaging the initial suspected diagnosis of a vallecular cyst was changed to the final diagnosis of a plunging ranula. The marsupialization of the cyst sac was performed. Outpatient follow‐up revealed a persisting ostium, indicating a continuous extravasation of the sublingual gland. The present case report describes an unusual clinical presentation of a plunging ranula, remaining above the mylohyoid muscle and protruding into the oropharynx, misdirecting to the first suspected diagnosis of a vallecular cyst. The case highlights the useful contribution of the MRI imaging for differential diagnoses and the need for criteria to indicate further investigations. [ABSTRACT FROM AUTHOR]

This article discusses the use of a local flap called the septal nasopharyngeal "kite flap" in the treatment of petrous apex cholesterol granuloma (PACG). PACG is a benign lesion of the temporal bone that can cause symptoms such as headache, hearing loss, and facial paresthesia. The study found that the septal nasopharyngeal "kite flap" is a reliable solution to prevent restenosis of PACG when used in conjunction with an endoscopic trans-pterygoid infra-petrous approach. The flap was found to be effective in preventing recurrence of symptoms and had no major complications. Further research is needed to validate these findings. [Extracted from the article]

The odontogenic keratocyst (OKC) is a frequently developing odontogenic cyst that accounts for 10%–14% of all jaw cysts. Due to the high recurrence rate, aggressive therapeutic techniques such as jaw resection and marsupialization are indicated. Following a conservative marsupialization procedure in which Carnoy's solution and an iodoform packing were used, the clinical, radiological, and histological evaluation of OKC in a 12-year-old female patient revealed no evidence of recurrence over the subsequent year of follow-up.

Symptomatic nasopharyngeal cysts are relatively uncommon. Here is a case report of 50 years of age female with hearing loss secondary to the nasopharyngeal cyst. She underwent endoscopic marsupialization and achieved normal hearing postoperatively.The study aims to determine the incidence of hearing loss, radiological patterns and histopathological findings associated with the nasopharyngeal cyst. [ABSTRACT FROM AUTHOR]

Rare non-odontogenic cysts of the soft tissue of the midface that form between the nasal vestibule and upper lip are known as nasolabial cysts. Treatment can be accomplished by surgical removal, injection of sclerosing material into the cyst, and endoscopic marsupialization. The aim of this study is to compare the effectiveness of Excision with sublabial approach versus Marsupialization with Transnasal Endoscopic approach in patients with Nasolabial cyst in terms of operating time, recurrence rate, postoperative pain and complications. Our study was Duration based prospective observational study with a Duration of four years from August 2018 till July 2022 with study population inclusive of 30 patients aged between 20 and 70 years who were diagnosed with a unilateral nasolabial cyst on the basis of clinical presentation, anatomical location, and computed tomography (CT) findings at ENT Department of our Tertiary Institution. The study used a randomized, single blind, parallel design with a total of 30 patients, which were randomly allocated to undergo Excision with sublabial approach (group A) in 15 patients (15 nasolabial cysts) and Marsupialization with Transnasal Endoscopic approach (Group B) in 15 patients (15 Nasolabial cysts). In the sublabial approach group, the mean operating time was 91.28 ± 3.1 min, whereas in the transnasal marsupialization group, it was 29.7 ± 3.2 min. These differences were statistically significant (P = 0.003). In the excision with sublabial approach and transnasal endoscopic marsupialization groups, the visual analogue scale (VAS) for postoperative pain was 5.9 ± 1.4 and 3.2 ± 0.6, respectively (P = 0.001). Ten patients in the sublabial approach group and five patients in the transnasal marsupialization group had one or more problems during the follow-up period which disappeared spontaneously within 4 weeks without long lasting issues. There were no recurrence lesions or obstructions of the marsupialized cyst opening in either group, according to physical, endoscopic and computed tomography examinations. Nasolabial cysts can be marsupialized transnasally, which offers many advantages over the more traditional sublabial excision method. Transnasal endoscopic marsupialization has the benefits of a shorter operating time, less postoperative pain, and a low complication rate. Therefore, we propose that Transnasal Endoscopic marsupialization be the treatment of choice for nasolabial cyst, replacing the conventional Excision with sublabial approach. [ABSTRACT FROM AUTHOR]

Cysts in the parotid region are more common in the gland than in the duct. Isolated cyst of parotid duct is a rare presentation. The treatment for most of the cystic lesions of the parotid or the parotid duct is the excision of the cyst with superficial parotidectomy. However, these lesions can be approached intra-orally for marsupialization achieving the same surgical results with less morbidity. This paper presents a rare case of parotid duct cyst which was managed by intraoral drainage and marsupialization. A 53-year-old female presented with swelling in the right cheek, associated with frequent fluid drainage inside the oral cavity for four months. Radiology and Fine needle aspiration revealed a benign parotid duct cyst with normal parotid gland. It was managed by a simple surgical technique of marsupialization. The patient was followed up for 1 year with no evidence of recurrence. Marsupialization obviates the need for parotidectomy in the simple cystic lesion of the parotid duct, unlike the cystic lesion in the gland per se and also reduces risk of recurrence. The simplicity and lack of major complications make it an effective treatment for salivary duct cysts. [ABSTRACT FROM AUTHOR]

Introduction: The pilonidal cyst is a chronic inflammatory condition of the skin and subcutaneous sacrocoxige tissue, with high incidence in young people and male sex. Surgical management includes open and closed techniques which use flaps. The objective is to describe the clinical and surgical charac)teristics of patients operated on for pilonidal cyst with open technique. Material and Method: Cohort, retrospective, observational and cross-sectional study. We included all patients operated on for pilonidal cyst using open techniques at the Hospital Clinic University of Chile between 2013 and 2019. Clinical and surgical characteristics was collected, such as type of open technique, operative time, healing time and definitive closure. Descriptive statistics were applied. Results: There were 250 patients diagnosed with pilonidal cyst since 2013, of which 84.8% were patients managed with open techniques; 60.8% were male. The average BMI was 26.8 with 24.5% of patients with obesity. 55.3% had been drained in the emergency room previously and 9.6% were relapses. The average size was 3.6 cm. The open techniques used were marsupialization, unroofing and McFee. The average healing time was 5.9 weeks and definitive closure occurs on average at 10.4 weeks; 4.7% relapsed. Conclusion: Surgery of the pilonidal cyst in our series corresponds mostly to open techniques (marsupialization and unroofing). The healing time, wound closure and the percentage of recurrences of patients operated on for pilonidal cyst is similar to that reported internationally [ABSTRACT FROM AUTHOR]

The odontogenic keratocyst (OKC) is a frequently developing odontogenic cyst that accounts for 10%-14% of all jaw cysts. Due to the high recurrence rate, aggressive therapeutic techniques such as jaw resection and marsupialization are indicated. Following a conservative marsupialization procedure in which Carnoy's solution and an iodoform packing were used, the clinical, radiological, and histological evaluation of OKC in a 12-year-old female patient revealed no evidence of recurrence over the subsequent year of follow-up. [ABSTRACT FROM AUTHOR]

Key Clinical Message A plunging ranula may present initially as an extensive vallecular cyst and correct diagnosis may be reached with the use of ultrasound, fluid aspiration for amylase detection, and MRI imaging. Abstract The ranula is a pseudocyst of the sublingual salivary gland and can be divided into two known subtypes. The simple ranula and plunging ranula. While the simple type can be found in the floor of the mouth, the plunging ranula usually pervades the mylohoid muscle and presents as a cervical swelling. The presented case should outline the difficulties in diagnostic and treatment of an uncommon expression of a mucocele above the mylohoid muscle without presenting either a cervical or an intraoral swelling, only extending towards the vallecula. We present a previously unreported clinical manifestation of a ranula of an 18‐year old male, which extends posteriorly, remaining confined in the supramylohyoid muscle space. The cystic lesion protrudes in the oropharynx, and clinically appears as an extensive vallecular cyst. On magnetic resonance imaging the initial suspected diagnosis of a vallecular cyst was changed to the final diagnosis of a plunging ranula. The marsupialization of the cyst sac was performed. Outpatient follow‐up revealed a persisting ostium, indicating a continuous extravasation of the sublingual gland. The present case report describes an unusual clinical presentation of a plunging ranula, remaining above the mylohyoid muscle and protruding into the oropharynx, misdirecting to the first suspected diagnosis of a vallecular cyst. The case highlights the useful contribution of the MRI imaging for differential diagnoses and the need for criteria to indicate further investigations.

AbstractA nasopalatine duct cyst (NPDC) is the most common type of non-odontogenic cyst in the maxillary region and oral cavity. Recently, a novel transnasal endoscopic approach has been described to allow marsupialization of NPDCs, with good outcomes. However, one common complication appears to be paresthesia of the palate around the upper incisors, which is thought to occur due to damage to the nasopalatine nerve following the septal incision. In this case report, we introduce a variant of this endoscopic technique that attempts to minimize damage to this nerve by adopting a septum-sparing flap. We report no complications, including no paresthesia, at the 3-month follow-up. We also report a novel ‘Mickey Mouse’ sign on MRI imaging associated with this NPDC.

Background: A dentigerous cyst is the second-most frequently observed odontogenic cyst, and an ameloblastoma is one of the most frequently observed odontogenic tumors. Both are mostly associated with an impacted mandibular third molar and have similar characteristics. Diagnostic difficulties often result in misdiagnosis and remain a challenge to overcome. Comprehensive clinical, radiographic, and histopathological views are essential to correctly diagnose the problem and formulate the most suitable treatment plan. Purpose: This case report aims to present a thorough approach to the diagnostic and surgical procedures involved in treating a dentigerous cyst that resembles an ameloblastoma by using marsupialization followed by enucleation. Case: This article presents the case report of a 27-year-old male patient with an infected dentigerous cyst resembling a unicystic ameloblastoma associated with a totally impacted lower mandibular left third molar. The patient had a history of swelling, pain, and pus drainage in the retromolar area. Symptoms subsided after antibiotic and analgesic prescriptions, but the lesion remained and was slowly progressing. The diagnostic approach began with a fine-needle aspiration biopsy, and the result confirmed a benign cystic lesion that was suspected to be an odontogenic tumor. Then an incisional biopsy was conducted under local anesthesia, diagnosing an infected dentigerous cyst. Case Management: Marsupialization and decompression using an obturator was preferred, followed by enucleation. Nine months later, a radiographic examination revealed satisfactory bone regeneration without recurrence. Conclusion: An incisional biopsy plays a vital role in establishing a definitive diagnosis. Marsupialization followed by enucleation offers an excellent combination of treatments achieving complete cyst removal, anatomical structure preservation, and bone regeneration with minimal complications.

A nasopalatine duct cyst (NPDC) is the most common type of non-odontogenic cyst in the maxillary region and oral cavity. Recently, a novel transnasal endoscopic approach has been described to allow marsupialization of NPDCs, with good outcomes. However, one common complication appears to be paresthesia of the palate around the upper incisors, which is thought to occur due to damage to the nasopalatine nerve following the septal incision. In this case report, we introduce a variant of this endoscopic technique that attempts to minimize damage to this nerve by adopting a septum-sparing flap. We report no complications, including no paresthesia, at the 3-month follow-up. We also report a novel 'Mickey Mouse' sign on MRI imaging associated with this NPDC. [ABSTRACT FROM AUTHOR]

Ameloblastoma is the most common benign odontogenic tumor with local invasion and high recurrence, which generally occurs in the jaw bones. Hypercalcemia is a common paraneoplastic syndrome that is commonly observed in patients with malignancies but rarely encountered in patients with benign tumors. Thus far, not many cases of ameloblastoma with hypercalcemia have been reported, and the pathogenic mechanism has not been studied in depth. This paper presents a case report of a 26-year-old male diagnosed with giant ameloblastoma of the mandible, accompanied by rare hypercalcemia. Additionally, a review of the relevant literature is conducted. This patient initially underwent marsupialization, yet this treatment was not effective, which indicated that the selection of the appropriate operation is of prime importance for improving the prognosis of patients with ameloblastoma. The tumor not only failed to shrink but gradually increased in size, accompanied by multiple complications including hypercalcemia, renal dysfunction, anemia, and cachexia. Due to the contradiction between the necessity of tumor resection and the patient's poor systemic condition, we implemented a multi-disciplinary team (MDT) meeting to better evaluate this patient's condition and design an individualized treatment strategy. The patient subsequently received a variety of interventions to improve the general conditions until he could tolerate surgery, and finally underwent the successful resection of giant ameloblastoma and reconstruction with vascularized fibular flap. No tumor recurrence or distance metastasis was observed during 5 years of follow-up. Additionally, the absence of hypercalcemia recurrence was also noted. [ABSTRACT FROM AUTHOR]

To study patients with spinal arachnoid cysts, who underwent cyst excision with dural defect repair or marsupialization, and their outcomes. The retrospective analysis involved reviewing the records of 38 patients who underwent surgical treatment for spinal arachnoid cysts in the Department of Neurosurgery at Christian Medical College, Vellore, between August 2004 and December 2022. The study examined the demographics, clinical presentation, imaging, surgical intervention, and outcomes of these patients. The majority of patients in the study were male (29/38, with 76.3%) and the thoracic region was the most common location for the cyst (17, with 44.7%). Weakness was the primary complaint and 94.7% of patients had myelopathy. The bladder was affected in 13 patients (34.2%). Of the 38 patients, 26 (71%) had cysts in extradural locations, while the rest were intradural. In total, 45.5% of intradural cysts were located in the ventral region. Seventeen (65.4%) had dural defects along the root sleeve and 29 (76.3%) underwent complete excision. All extradural cysts underwent complete excision and repair of the dural defect. Thirty patients (78.9%) experienced improved outcomes with reduced spasticity and improved weakness. One patient developed new-onset weakness postoperatively due to epidural hematoma. The mean follow-up period was 41 months and one patient experienced a recurrence. Spinal arachnoid cyst is a rare benign spinal condition that is typically treated with surgery in symptomatic patients. Surgical intervention may involve either the excision of the cyst or marsupialization. [ABSTRACT FROM AUTHOR]

Impaction of the maxillary central incisor is very rare compared to impaction of third molars and canine. It impacts to the facial aesthetic and psychological of individuals. One of the etiologies is cystic formation that inhibits the eruption of the tooth. Dentigerous cysts are the most common type of odontogenic cysts. A multidisciplinary approach of surgical exposure and orthodontic force expected impacted maxillary central incisor down to proper position. This paper presents a case of an impacted maxillary incisor with a dentigerous cyst that was managed by combined orthodontic and minor surgical techniques. Case(s): A 19-year-old male patient complained about the absence of an upper left permanent central incisor since he was 14 years old. Objective examination showed an edentulous area of tooth 21 with narrowing space but without midline shift. The impacted tooth was performed by minor surgical exposure and the cyst was performed by marsupialization. A gold chain was bonded to the labial surface of the impacted tooth. The orthodontic treatment used the pre-adjusted technique with bonded MBT 0.022 brackets. NiTi open coil springs were placed to create space for the traction of impacted tooth 21. Finishing and detailing using SS 0.016 x 0.022. Hawley retainer was used as a retain. [ABSTRACT FROM AUTHOR]

Pulpectomy is a common treatment for severe carious lesions in primary molars. Care should be taken during pulpectomy of the primary teeth for successive permanent teeth. This case series report aimed to describe the cases of three patients who experienced excessive extrusion of canal filling materials and file separation during primary molar pulpectomy. The presence of separated files or excessive overfilling materials observed around successive permanent tooth germs leads to underdevelopment and may trigger cystic changes owing to abscess formation. The most important aspect is to preserve the unerupted successive developing permanent tooth. Therefore, clinicians should consider the anatomy of the primary molars prior to endodontic treatment, be careful when manipulating instruments during pulpectomy, provide appropriate treatment if iatrogenic incidents occur during endodontic treatment, and perform close follow-up to ensure the successful development and eruption of subsequent permanent teeth. [ABSTRACT FROM AUTHOR]

Introduction: A laryngocele is an abnormal dilatation of the laryngeal saccule. It is asymptomatic most of the time so its true incidence is unknown. Depending on the site, symptoms may vary from a lump sensation in the throat to breathing difficulty. Radiologic confirmation of the diagnosis is a must. Report: A 50-year-old diabetic gentleman presenting with acute airway obstruction was evaluated and found to have an internal laryngopyocele which was managed with IV antibiotics and an endoscopic approach (draining and marsupialization) after securing the airway by tracheostomy. A review of the literature reveals that there is no consensus to manage such patients due to the rarity of the problem. The patient was decannulated in 5 days and made a good recovery. Conclusion: We advocate an endoscopic approach for internal laryngopyocele in emergency situations as it can expedite recovery due to less morbidity when compared to an external approach.

Marsupialization, or Partsch 1 technique, is a very common treatment technique used in more extensive cyst lesions. It is considered a more conservative and easy-to-perform treatment, although cystectomy or Partsch 2 is the technique of choice for treating odontogenic cysts. Marsupialization promotes a reduction in the existing intracystic pressure, leading to a reduction in the cyst and subsequently bone neoformation. The aim of this article was to present a brief literature review on marsupialization and to report a clinical case. Case report: Male, melanodermic, 54 years old. The treatment of choice was marsupialization, mainly because the patient was a user of antiresorptive drugs as an adjuvant therapy for prostate cancer, minimizing the risk of bone exposure. The result of the anatomopathological examination was compatible with a periapical cyst. Conclusion: After one year's follow-up, we were able to see total regression of the facial deformity previously seen intraorally and extraoral. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of fistulotomy and fistulotomy with marsupialization in the management of simple anal fistula. Study Design: Randomized Controlled study. Setting: Department of Surgery, District Head Quarter Hospital, Mardan, Pakistan. Period: 1st September 2021 to 31st August 2022. Material & Methods: A total of 60 Patients coming to hospital with simple anal fistula were randomized into two equal groups. In group A, 30 patients were treated with fistulotomy, while in group B, 30 patients were treated with fistulotomy with marsupialization. The primary outcome was set as time required for complete wound healing. Secondary outcomes were operation time, postoperative pain, anal incontinence, incidence of recurrence and patient satisfaction. Results: The mean wound healing time after 6 weeks was shorter in group B in comparison to group A (4.7± 0.74 versus 6.4± 0.85 weeks; p=0.0001). There was no significant difference in mean operation time between Group B and Group A. The difference in mean pain score was also not statistically significant. There was no significant difference in the incidence of anal incontinence, incidence of recurrence and patient’s satisfaction among two groups. Conclusion: Fistulotomy with marsupialization is more effective procedure than fistulectomy alone in shape of early wound healing without increase in operation time and therefore can be taken as surgical procedure of choice for the simple anal fistula. [ABSTRACT FROM AUTHOR]

Objectives This article reports the management of a case of a 32-year-old male who presented with progressive weakness in the lower limbs and spastic paraparesis secondary to an intramedullary arachnoid cyst (IMAC). For literature review, the authors used the phrase "intramedullary arachnoid cyst" in PubMed search engine. 23 articles describing cases with IMAC were included in this review, with a total of 26 patients. Materials and Methods We report a case with long term recurrant intramedullary arachnoid cyst and present a review on spinal intramedullary arachnoid cyst. Result IMAC is showing bimodal incidence and trending to occur below 10 years and after 30 years. However, rarely, it should be considered in the differential diagnosis of intramedullary cystic lesions. Authors suggest doing laminoplasty or fusion for the pediatric patients to prevent kyphoscoliosis deformity in the long run, but doing early surgery to gain better outcome. Resection of the cyst wall should be done as much as possible; if it could not be achieved, then marsupialization or cysto-subarachnoid shunt should be considered. Aspiration alone or fenestration is not enough to eradicate the cyst. Long-term and prospective studies are recommended to achieve the best treatment options. Conclusion Review supports early surgical treatment of symptomatic IMACs with resection of the cyst wall as much as possible. [ABSTRACT FROM AUTHOR]

Background and Objectives: Dentigerous cyst (DC) is the second most common developmental odontogenic cyst. On radiographic images, it usually seen as a well-defined unilocular radiolucency in the area surrounding the crown of an unerupted tooth. This study aims to report a case of giant DC in a 9-year-old boy who was treated conservatively. Case Report: This study reports a rare case of a mandibular DC associated with the crown of unerupted canine in a 9-year-old boy complained of swelling for about 5 months who had been treated by marsupialization. Conclusion: Conservative treatments for the large inflammatory DCs in children can lead to good results, ensuring the normal development of teeth, and proper bone repair.

Nasolacrimal duct (NLD) cysts are a rare comorbidity of dacryocystocele. We describe the case of a 0-day-old female infant with neonatal respiratory distress syndrome developing immediately after birth. Nasal endoscopy and magnetic resonance imaging revealed bilateral NLD cysts in the inferior meatus. A nasopharyngeal airway was inserted into the right nasal cavity as first aid, which effectively improved the patient’s respiratory condition. However, her respiratory condition deteriorated rapidly at 29 days of age. Hence, microdebrider-assisted endoscopic marsupialization was performed at 61 days of age. This procedure does not require any special techniques, and the cyst wall was adequately removed under general anesthesia. Her respiratory condition improved immediately postoperatively, and no complications or recurrence of the cyst have been reported to date. Neonatal respiratory distress syndrome due to congenital NLD cyst can present without abnormal findings around the eye, highlighting the importance of considering this condition as a differential diagnosis.

Key Clinical Message: 3D printing can improve surgical planning and coordination between the healthcare team and serve as a valuable educational tool for students. Although the occurrence of odontogenic keratocysts (OKCs) in the maxillofacial region is not uncommon, their aggressive growth behavior requires advanced surgical techniques for minimal recurrence. The current case report describes the use of a multicolored 3D‐printed model as an interactive visual aid for the surgical planning and management of an OKC treated with a minimally invasive surgical decompression technique. A cone‐beam computed tomography scan of the patient showed a profound OKC involving the left side of the body of the mandible. A 3D printer was used to print a multicolor resin model of the patient's OKC lesion within the mandible. The printed model was successfully used as a planning tool for surgical intervention (i.e., marsupialization and enucleation) of the OKC. The model was also used as a handheld interactive visual aid for dental students, so they could more effectively understand the anatomical and surgical complexity of the case. The novel use of the multicolor 3D‐printed model for treatment of this OKC improved visualization of the lesion during surgical planning and was a valuable teaching tool for educational discussion of this case. [ABSTRACT FROM AUTHOR]

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Objective: The present study aims to demonstrate the surgical and patientreported outcomes of marsupialization after fistulotomy in intersphincteric and low transsphincteric fistulas. Methods: A consecutive number of 100 patients who were diagnosed with an intersphincteric (IS) or a low transsphincteric (LTS) fistula and underwent fistulotomy with or without marsupialization were included in this study. The study cohort was divided into two groups: fistulotomy with and without marsupialization. Results: The study population consisted of 77 male patients with a mean age of 37.59±10.83 years. The number of patients with IS fistulas was 56 (56%). The marsupialization was performed in 36 patients, 26 of them with LTS fistula. The mean VAS score was significantly lower in the marsupialization group than the no-marsupialization group (p=0.035). Moreover, the duration of wound healing was demonstrated significantly shorter in the marsupialization group than nonmarsupialization group (p=0.039). Conclusion: Marsupialization is an effective and feasible technique for fistulotomy wounds in patients with simple fistulas in terms of reducing postoperative pain and duration of wound healing. [ABSTRACT FROM AUTHOR]

The dentigerous cyst is the second most common odontogenic. The prevalence rates ranging from 0.8% to 3.6% in the general population. It affects people especially at the second and third decade of life with a male predilection. It presents a preference for the mandibular region particularly for the second lower premolar. Surgical marsupialization or decompression are the most conservative treatment modalities as it prevents the risks of cyst removal as nerve injuries and preserves the unerupted tooth. Two clinical cases of two young patients presenting a dentigerous cyst involving impacted teeth, which were successfully treated by decompression will be reported in order to highlight the benefits and limits of cyst decompression as well as detailing its operating protocol and its instructions. [ABSTRACT FROM AUTHOR]

Key Clinical Message 3D printing can improve surgical planning and coordination between the healthcare team and serve as a valuable educational tool for students. Abstract Although the occurrence of odontogenic keratocysts (OKCs) in the maxillofacial region is not uncommon, their aggressive growth behavior requires advanced surgical techniques for minimal recurrence. The current case report describes the use of a multicolored 3D‐printed model as an interactive visual aid for the surgical planning and management of an OKC treated with a minimally invasive surgical decompression technique. A cone‐beam computed tomography scan of the patient showed a profound OKC involving the left side of the body of the mandible. A 3D printer was used to print a multicolor resin model of the patient's OKC lesion within the mandible. The printed model was successfully used as a planning tool for surgical intervention (i.e., marsupialization and enucleation) of the OKC. The model was also used as a handheld interactive visual aid for dental students, so they could more effectively understand the anatomical and surgical complexity of the case. The novel use of the multicolor 3D‐printed model for treatment of this OKC improved visualization of the lesion during surgical planning and was a valuable teaching tool for educational discussion of this case.

Objective In this report we present a rare case of a large cyst of Skene gland in a female patient with a palpable vaginal mass persisting for at least 2 years. Case Report A 67-year-old female admitted to the department of urology due to the presence of “a vaginal mass” for the past 2 years. A cyst of Skene's duct was suspected based on clinical manifestation and findings of magnetic resonance imaging showing an extensive cyst formation in the upper vaginal area and anterior to the urethra. Based on these findings, a decision for surgical removement of the cyst was made. The cyst was incised, drained, and marsupialized. The postoperative recovery was uneventful, and the patient was discharged on the second postoperative day. Conclusion High clinical suspicion is important to reach this rare diagnosis. Partial excision and marsupialization of the cyst is a simple procedure with low morbidity, without recurrence, and excellent results.

Abstract The dentigerous cyst is the second most common odontogenic. The prevalence rates ranging from 0.8% to 3.6% in the general population. It affects people especially at the second and third decade of life with a male predilection. It presents a preference for the mandibular region particularly for the second lower premolar. Surgical marsupialization or decompression are the most conservative treatment modalities as it prevents the risks of cyst removal as nerve injuries and preserves the unerupted tooth. Two clinical cases of two young patients presenting a dentigerous cyst involving impacted teeth, which were successfully treated by decompression will be reported in order to highlight the benefits and limits of cyst decompression as well as detailing its operating protocol and its instructions.

The odontogenic keratocyst (OKC) is among the most aggressive odontogenic cysts because of its high recurrent rate. This study's objective was to describe a 7-year radiological and clinical follow-up of an OKC with two recurrences and a combination of surgical treatments. The cyst contents were drained at the biopsy to allow decompression, and then marsupialization (Partsch I) was carried out with good results. In the following two years, the endodontic and radiological evaluation of the neighboring teeth indicated endodontic avoidance. The remaining OKC enucleation (Partsch II) with chemical curettage and suture was performed two years after the first presentation, and the multifocal recurrences developed were also treated by enucleation and chemical curettage. At the last radiological follow-up, no recurrence was evident. Based on our experience, we concluded that patients diagnosed with a OKC should be radiologically evaluated at least once a year for at least 7 years, the endodontic diagnosis and treatment of neighboring teeth should be performed as early as possible, and the combination of surgical treatment and the long follow-up period is challenging. [ABSTRACT FROM AUTHOR]

The most common developmental odontogenic cysts of the jaw are dentigerous cysts, which originate from permanent teeth impacted, embedded, or unerupted. They develop as a result of fluid accumulating between the dental crown of an immature tooth and its decreased enamel epithelium.This article presents a left maxillary dentigerous cyst in a 10-yearold boy. Enucleation was the treatment of choice. Long-term followup revealed good healing of the bony lesion. [ABSTRACT FROM AUTHOR]

Aim: To evaluate long-term results in the surgical treatment of sacrococcygeal pilonidal disease (SPD) comparing the different surgical techniques used, complications, healing time and recurrence. Material and Method: Retrospective cross-sectional study. The files of the patients operated on for EPS between January 2017 and August 2021 were reviewed. For follow-up, information was obtained from the records of the periodic controls in our center; those who did not continue with these controls were contacted by telephone. Results: 309 cases were collected, with a mean follow-up of 15.6 months. The most used techniques for the chronic phase of EPS were marsupialization and Karydakis, achieving complete wound healing in 54.5 and 18.2 days, respectively. The presence of complications prolonged the healing time by 46.5 days in Karydakis, with minimal impact on marsupialization. The recurrence rate was lower in Karydakis and in the acute stage when unroofing and curettage were performed. Antibiotic prophylaxis did not increase the risk of postoperative complications. Discussion: The development of postoperative complications has a greater impact on the healing of the closed technique than in the open technique, the last one seems to be more tolerant in terms of healing in the presence of complications. Conclusion: The intervention with the Karydakis technique achieves healing of the surgical wound in less time than marsupialization, however, when complications develop, this time increases 3.5 times more. Recurrence was lower in Karydakis. In abscess weaning and curettage is recommended over the exclusive drainage. [ABSTRACT FROM AUTHOR]

Bilateral dentigerous cysts (DC) associated with unerupted mandibular first molars in a non-syndromic pediatric individual are rare. Secondary infections may lead to complications, such as discomfort due to pain, disfigurement caused by enlargement of the cyst with cortical expansion of the jawbone, displacement of teeth and paraes-thesia of the adjacent nerve. This case report describes the occurrence of bilateral DC in an eight-year-old patient. Marsupialization was the treatment of choice to preserve the permanent teeth and other adjacent tissues. [ABSTRACT FROM AUTHOR]