Odontogenic myxoma of the maxilla operated on with endoscopic modified medial maxillectomy procedure and curettage after tooth extraction

Abstract

Odontogenic myxoma is a relatively rare benign tumor of the maxillary or mandibular bone. Surgery is the first-choice elective treatment because odontogenic myxoma causes facial deformity or diplopia. The surgical procedure remains controversial. Some surgeons perform disfiguring radical surgery and others favor simple enucleation with curettage. A 40-year-old woman visited our hospital with complaints of right cheek discomfort and nasal congestion. A CT and MRI scan showed a 44 mm-sized tumor in the right maxillary sinus. Under local anesthesia, a biopsy of the maxillary sinus was performed via the transnasal passage, and the tumor was diagnosed with odontogenic myxoma. Under general anesthesia, the procedure of endoscopic modified medial maxillectomy （EMMM） and curettage after tooth extraction was performed. By performing EMMM and tooth extraction concurrently, the tumor could be approached from both the extraction socket and the nasal cavity, and it was possible to perform curettage reliably with a good field of vision.