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Douglas JE, Wei K, Panara K, Lee DJ, Kohanski MA, Shanti RM, Panchal N, Palmer JN, Adappa ND. Combined Transnasal, Transoral Excision of Odontogenic Cysts Offers Reduced Recurrence Rates and Favorable Sinonasal Outcomes. Laryngoscope 2024; 134:2489-2491. [PMID: 38581361 DOI: 10.1002/lary.31441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/14/2024] [Accepted: 03/26/2024] [Indexed: 04/08/2024]
Abstract
Odontogenic cysts impact the adjacent dentition and maxillary sinus. A combined transnasal, transoral approach for removal offers reduced recurrence rates and favorable sinonasal outcomes compared with historic transoral-only approaches.
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Affiliation(s)
- Jennifer E Douglas
- Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, U.S.A
| | - Kimberly Wei
- Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, U.S.A
| | - Kush Panara
- Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, U.S.A
| | - Daniel J Lee
- Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, U.S.A
| | - Michael A Kohanski
- Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, U.S.A
| | - Rabie M Shanti
- Department of Oral and Maxillofacial Surgery, Rutgers School of Dental Medicine, Newark, New Jersey, U.S.A
| | - Neeraj Panchal
- Department of Oral and Maxillofacial Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, U.S.A
| | - James N Palmer
- Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, U.S.A
| | - Nithin D Adappa
- Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, U.S.A
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Ragab AA, Abo El Naga HAR. Endoscopic-assisted approaches for enucleation of invaded sinonasal region by benign odontogenic cysts: a case series study. Egypt J Otolaryngol 2022. [DOI: 10.1186/s43163-022-00327-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Background
During surgical planning for the excision of odontogenic cysts and tumors, surgeons should consider choosing the appropriate endoscopic approach to reach all parts of the maxillary sinus and cyst walls during its enucleation. Using the endoscopic trans-nasal approaches results in less than one-third of the maxillary sinus being reached regardless of antrostomy or angled instruments used. Also, the expansion process and involvement of maxillary sinuses in odontogenic cysts and tumors are variable, adding more difficulties during excision. This study aimed to assess the expansion process of large benign odontogenic cysts and tumors involving nasoantral regions and adaptability to different endoscopic approaches for enucleation. Six patients were included in this case series study. Preoperative panoramic views plain film radiography, and computed tomography scans were obtained. Lesion characteristics, relation to teeth origin, the nose, and maxillary sinus wall displacement, location of lesions about typical vertical and horizontal nasomaxillary constructions, and associated inflammation of the paranasal sinuses were evaluated. Three surgical approaches were tailored, allowing viewing and endoscopic enucleation.
Results
Four periapical (radicular) cysts, one ameloblastoma, and one calcifying epithelial odontogenic tumor, ranging in size from 3 to 5 cm, were enucleated endoscopically in patients aged 15–40 years. Intra-sinus expansion of the cyst and lesion level above the nasal floor allowed endoscopic enucleation using wide middle meatal antrostomy in 1 (17%). Lesions localized to the anterior wall and the nasal process of the maxilla permitted endonasal minimal rhinotomy approach in 1 (17%). Central lesions, cyst extension below the level of the nasal floor, and lateral wall expansion with or without anterior maxillary wall scalloping had adequate exposure using a minimal sublabial approach in four patients (67%). Together with its role in complete enucleation, endoscopy allowed associated rhinosinusitis surgical treatment in five patients (83%).
Conclusion
Tailoring surgical approaches to the expansion process allowed endoscopic enucleation of large odontogenic cysts/tumors without wall remnants. The integrity of the Schneiderian membrane was preserved, protecting the critical surrounding structures.
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Molteni M, Bulfamante AM, Pipolo C, Lozza P, Allevi F, Pisani A, Chiapasco M, Portaleone SM, Scotti A, Maccari A, Borloni R, Felisati G, Saibene AM. Odontogenic sinusitis and sinonasal complications of dental treatments: a retrospective case series of 480 patients with critical assessment of the current classification. ACTA ACUST UNITED AC 2021; 40:282-289. [PMID: 33100340 PMCID: PMC7586196 DOI: 10.14639/0392-100x-n0457] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 12/24/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Marco Molteni
- Otolaryngology Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Italy
| | - Antonio Mario Bulfamante
- Otolaryngology Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Italy
| | - Carlotta Pipolo
- Otolaryngology Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Italy
| | - Paolo Lozza
- Otolaryngology Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Italy
| | - Fabiana Allevi
- Maxillofacial Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Italy
| | - Antonia Pisani
- Otolaryngology Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Italy
| | - Matteo Chiapasco
- Oral Surgery Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Italy
| | - Sara Maria Portaleone
- Otolaryngology Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Italy
| | - Alberto Scotti
- Otolaryngology Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Italy
| | - Alberto Maccari
- Otolaryngology Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Italy
| | - Roberto Borloni
- Otolaryngology Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Italy
| | - Giovanni Felisati
- Otolaryngology Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Italy
| | - Alberto Maria Saibene
- Otolaryngology Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Italy
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Halpern LR, Adams DR. Present and Future Trends in Transoral Surgical Intervention: Maximal Surgery, Minimally Invasive Surgery, and Transoral Robotic Surgery. Oral Maxillofac Surg Clin North Am 2021; 33:263-273. [PMID: 33546936 DOI: 10.1016/j.coms.2020.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Oral and maxillofacial surgery (OMFS) has undergone a renaissance/metamorphosis as a specialty and in the technologic innovations that have enhanced the surgical care of patients. This article reviews traditional maximal transoral approaches in the management of common pathologic lesions seen by OMFS, and compares these techniques with a literature review that applies minimally invasive technology and innovative robotic surgery (transoral robotic surgery) to treat similar lesions. The traditional approaches described in this article have transcended generations and future trends are suggested that will improve the training of the OMFS legacy as clinicians move forward in the care of patients.
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Affiliation(s)
- Leslie R Halpern
- Oral and Maxillofacial Surgery, University of Utah, School of Dentistry, 530 South Wakara Way, Salt Lake City, UT 84108, USA.
| | - David R Adams
- Oral and Maxillofacial Surgery, University of Utah, School of Dentistry, 530 South Wakara Way, Salt Lake City, UT 84108, USA
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Consolo U, Bellini P, Mattioli F, Lizio G. A conservative transnasal endoscopic and intraoral approach in a case of a maxillary dentigerous cyst. ACTA ACUST UNITED AC 2019. [DOI: 10.1111/ors.12445] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- U. Consolo
- Department of Surgery, Medicine Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance School of Dentistry University of Modena and Reggio Emilia Modena Italy
| | - P. Bellini
- Department of Surgery, Medicine Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance School of Dentistry University of Modena and Reggio Emilia Modena Italy
| | - F. Mattioli
- Unit of ENT University of Modena and Reggio Emilia Modena Italy Modena Italy
| | - G. Lizio
- Department of Surgery, Medicine Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance School of Dentistry University of Modena and Reggio Emilia Modena Italy
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