Mandibular cyst is a common benign lesion. Generally, cystectomy is performed after bone removal, the extent of which depends on the size of the cyst. However, incision of the oral mucosa and elevation of the periosteum result in postoperative pain and swelling. To reduce these symptoms, minimally invasive access to the lesion is needed. Recently, an endoscope has been used to enable minimally invasive surgery in the oral and maxillofacial region, such as for the fixation of subcondylar fractures and sialoendoscopy. We report the endoscopically-assisted removal of a mandibular cystic lesion, treated by minimally invasive surgery.
A 63-year-old man was referred to our department. Panoramic radiography and CT scans showed a cystic lesion with an impacted third molar in the right mandibular ramus. The patient underwent endoscopically-assistedremoval of the mandiblar cystic lesion under general anesthesia. To reduce extensive bone removal and identify the extent of the lesion, we used endoscopes(KARL STORZ, Germany)that were 4 mm in diameter and had tip angles of 30 °and 70 °. First, a 2-cm mucosal incision was made at the anterior border of the mandibular ramus. The periosteum was elevated, and a box-shaped osteotomy was performed. The endoscope was inserted into the lesion. The cystic wall and third molar were identified. Then, complete enucleation of the lesion and tooth was performed under endoscopic guidance. Endoscopically-assisted removal of mandibular cystic lesions enables not only minimally invasive access to lesions, but also allows the removal of lesions to be confirmed.
