Dermoid cysts of floor of the mouth: report of four cases

Clinical Results Evaluation of Patients With Submental Mass Through Endoscopy-Assisted Transoral Surgery

BACKGROUND

Surgical resection through extraoral approach is the first choice for submental mass but leaves a visible scar. This study introduces an endoscopy-assisted transoral approach to resect submental mass and evaluates the clinical results.

PATIENTS AND METHODS

From September 2018 to December 2019, 5 patients with submental mass underwent surgical resection through endoscopy-assisted transoral approach. The swallowing, speech, and appearance domains of the University of Washington Quality of Life questionnaire were assessed preoperatively and at 3 months postoperatively.

RESULTS

Each mass was completely removed without rupture. No patient developed any permanent postoperative complications. The function and aesthetic outcomes were excellent without recurrence.

CONCLUSIONS

Endoscopy-assisted transoral approach for resection of submental mass is a reliable technique that achieves excellent postoperative aesthetics and functional results.

Sublingual dermoid cyst in an infant: A case report and review of the literature

Dermoid cysts usually occur later in the second decade of life; we present the approach of an unusual case of an infant who presented a cyst within the oral cavity, which is important because it can be confused with other pathologies.

Epidermoid cyst of the tongue causing airway obstruction

Epidermoid cyst occurring within the tongue is rare. The aim of this article is to discuss the management of an adult patient who presented with respiratory obstruction due to this congenital epidermoid cyst within the tongue. A 32-year-old male patient who was brought to the accident and emergency department of the University of Port Harcourt Teaching Hospital, Port-Harcourt, Rivers State, Nigeria was presented. He came with a history of difficulty in breathing as a result of a slow growing swelling of the tongue which started from birth. There was associated pain, difficulty in speech and mastication as the swelling increased in size. Detailed physical examination, sonographic imaging and histopathology were carried out. On examination, patient was acutely ill-looking, in severe respiratory distress, febrile, mildly pale and dehydrated but anicteric. Extra-oral examination revealed mildly protruded upper and lower dento-alveolar arch as well splaying and recession of the anterior and posterior teeth of the upper arch. Intra-oral examination revealed moderately tender, fluctuant and grossly enlarged tongue obstructing the oro- and nasopharyx. A diagnosis of dermoid cyst was made and the patient was booked for surgery after resuscitation. Excision of the cyst was done under general anaesthesia/naso-tracheal intubation by an intra-oral approach. Ultrasound was able to give a thorough assessment of the cystic nature of the swelling while post-operative histopathology was used to confirm the specific type of teratoma. The relationship of the cyst to the intrinsic and extrinsic muscles of the tongue and mylohyoid muscle was relevant to the surgical approach to the lesion.

Review of floor of mouth dysontogenic cysts

OBJECTIVES

We report the common surgical approaches, incidence of sinus tracts, and recurrence rates of floor of mouth dysontogenic (epidermoid, dermoid, and teratoid) cysts in the pediatric population.

METHODS

Data were derived from PubMed, Medline, Embase, Google Scholar, and manual searches. Three cases from the senior author's (J.P.M.) practice were included. All English-language studies consisting of floor of mouth dysontogenic cysts were included. Case reports of tongue dysontogenic cysts, mandibular dysontogenic cysts, maxillary dysontogenic cysts, and dysontogenic cysts in the neck below the hyoid bone were excluded.

RESULTS

There are 198 case reports, including those presented here, of floor of mouth dysontogenic cysts. They are more common in male patients (55.1%), and the most common location is in the sublingual space (104 or 52.5%). Most floor of mouth dysontogenic cysts can be excised by an intraoral approach. There are 5 reported cases in the literature of recurrent dysontogenic cysts and 11 cases of multiple floor of mouth dysontogenic cysts.

CONCLUSIONS

Floor of mouth dysontogenic cysts most commonly present in the sublingual space, and most can be excised by an intraoral approach. Multiple dysontogenic cysts often require a combination of intraoral and extraoral approaches. Recurrence of a dysontogenic cyst may be secondary to a tract not identified at the time of surgery.

Surgical excision of intra-oral dermoid cyst under local anaesthesia: a review of nine cases

OBJECTIVE

The purpose of this article is to highlight the effectiveness of local anaesthesia in the surgical excision of intral-oral dermoid cyst in the absence of available modern and efficient general anaesthetic options as experienced in our environment.

PATIENTS AND METHODS

A retrospective review of nine patients with intra-oral dermoid cysts seen at the oral and maxillofacial surgery units of three specialist hospitals in eastern Nigeria was carried out between 1996 and 2007. We used simple clinical findings and the aspiration technique for our provisional diagnosis and treated our patients by using local anaesthesia, which contains 2% lignocaine hydrochloride in 1: 80,000 adrenaline.

RESULTS

Out of the nine cases seen, the male-to-female ratio was 2:1, representing six male and three female. The age range was 13-22 years, with a mean age of 19 years. The use of local anaesthesia was uneventful and despite the limited options of treatment and the absence of advanced imaging techniques we achieved total success and good results in all nine patients.

CONCLUSION

The anaesthetic difficulties and uncertainties associated with the management of intral-oral dermoid cysts especially in an environment that lack modern general anaesthetic options can be avoided by the use of local anaesthesia. This may, therefore, be an effective alternative to difficult and sometime expensive general anaesthetic methods used in developed countries and could be emulated by oral and maxillofacial surgeons in poorer countries.

Surgical management of a large median dermoid cyst of the neck causing airway obstruction. A case report

INTRODUCTION

Dermoid cysts of the floor of the mouth and submandibular space represent an unusual clinical entity.

CASE REPORT

A case of an enlarged median dermoid cyst in a young female adult causing obstruction of the airway is reported.

DISCUSSION

The need of an extraoral and intraoral incision for the removal of the cyst is discussed, along with a review of the literature.