Marsupialization of mandibular cystic lesions, clinical observations of 23 cases.

1. Marsupialization was performed on 23 cases of cystic lesions of the jaw at the Department of Oral Surgery, Okayama University Hospital in the recent five years. 2. These patients were divided into 4 groups according to their age; namely, group A of those under IS years old, group B of those between 15 and 30 years old, group C of those between 31 and 60 years old, and group D of those over 61 years old, and the results of postoperative findings were compared with those of preoperative ones. 3. In group A of the four groups the most favorable results were obtained after marsupialization and reduction of the tumor was remarkable, even in a case of ameloblastoma, as compared with groups B, C and D. 4. Cure of lesions took somewhat a longer period of time in group B than in group A, but all the cystic lesions were reduced favorably after operation. 5. The reduction in cysts in groups C and D was markedly slower when compared with that in groups A and B, but the marsupialization surgery seems to be desirable in some cases. ∗PMID: 4249893 [PubMed indexed for MEDLINE] Copyright c ©OKAYAMA UNIVERSITY MEDICAL SCHOOL Acta Med. Okayama 24, 373-385 (1970) MARSUPIALIZATION OF MANDIBULAR CYSTIC LESIONS CLINICAL OBSERVATIONS OF 23 CASES Katsumi NISHIJIMA*, Tomonari MORITA**, Yasuhiro KANEHIRA and Mitsuru HIGUCHI* ** Department of Oral Surgery, Okayama University Medical School, Okayama, Japan (Director: Prof. Y. Watanabe) Received for publication, April 28, 1970 As a conservative treatment in the field of oral surgery Partsch method (marsupialization) has been used for many years in the treatment of various cystic lesions of the jaw, but as for marsupialization attempted for the treatment of ameloblastoma there have been a few descriptions, such as those by SELDIN (1944) (9, 10), OBATA (1962) (6, 7), TOMITA et at. (1963) (12) and NISHIJIMA et at. (1969) (4,5). Only the paper by NISHIJIMA et at. was on a comparative study on the follow-up results of this technic among various lesions in children, adults and persons of advanced age. The present paper deals with the results of our marsupialization applied to some cases of ameloblastoma and other cystic lesions during the recent five years in our department. MATERIALS AND METHODS Subjects of this study are only those with cystic lesions whose systemic examinations have indicated that operation is possible and only those who have shown no malignancy. Local anesthesia was used in most of these cases, but general anesthesia was applied to a few cases with extensive tumors. Marsupialization was made in the oral cavity, particularly, at a thinner portion of the bone wall of the superficial layer in order to minimize postoperative functional disturbances as much as possible. Extent of marsupialization depends upon the size of tumor. All the tumors were of over thumb tip size and the marsupialization was about 10 mm x 10 mm or more. As postoperative managements acrylic tubes or gauze was inserted through * Assistant Professor, ** Instructor *** and Clinical Assistant, Department of Oral Surgery, Okayama University Medical School The main part of this report was read at the Third Congress of the Japanese Society of Pedodontics held on May 8, 1965, and at 23rd Congress of the Japanese Stomatological Society on April 26, 1969. 373 1 Nishijima et al.: Marsupialization of mandibular cystic lesions, clinical Produced by The Berkeley Electronic Press, 1970 374 K. NISHIJIMA, T. MORITA, Y. KANEHIRA and M. HIGUCHI the opening in order to prevent shrinkage, and tumors were curetted and irrigated daily for one week after operation. Thereafter patients were instructed to visit us periodically once or twice a week for postoperative care and observation. In addition, antibiotics were administered for prevention of infection. CRITERIA FOR DETERMINATION OF TUMOR SHRINKAGE AFTER OPERATION For the purpose of comparing the preoperative facial expression, oral findings and x-ray findings with those after marsupialization, these findings and the state of the tumor shrinkage or the radiolucent area through the local site were observed. In some cases of extensive cysts, concurrently preoperative and postoperative cephalometric tracings are observed to see the extent of cyst shrinkage in the radiolucent area. Group A Case No. Age Sex 1 13 '0 Histologic Diag. Epidermoid cyst ('M'j'M areas) First Visit Exam. 11/7/64 TABLE 1. SUMMARY OF 23 CASES Preop. Findings Asymmetrical facial contour due to swelling of It. cheek Large bilat. radiolucent area of the mand. 2