J Korean Assoc Oral Maxillofac Surg.  2023 Oct;49(5):287-291. 10.5125/jkaoms.2023.49.5.287.

Is conservative treatment (enucleation using modified Carnoy’s solution) of odontogenic keratocyst in the maxilla good prognosis?

• Jeon WY
• Park JH
• Ku JK
• Baek JA
• Ko SO

• KMID: 2547573
• DOI: http://doi.org/10.5125/jkaoms.2023.49.5.287

Abstract

Odontogenic keratocysts (OKCs) located in the maxillae have rarely been reported in the literature. Standard treatment modalities for OKC range from marsupialization to marginal resection. However, most of the studies on OKC treatment have been related to mandibular OKCs. The anatomical structure and loose bone density of the maxillae and the empty space of the maxillary sinus could allow rapid growth of a lesion and the ability to tolerate tumor occupancy in the entire maxilla within a short period of time. Therefore, OKCs of the maxillae require more aggressive surgery, such as resection. As an alternative, this report introduces a modified Carnoy’s solution, a strong acid, as an adjuvant chemotherapy after cyst enucleation. This report describes the clinical outcomes of enucleation using a modified Carnoy’s solution in patients with large OKCs on the posterior maxillae. In three cases, application of a modified Carnoy’s solution had few side effects or morbidity. Each patient was followed for four to six years, and none showed any signs of recurrence. In conclusion, adjuvant treatment with a modified Carnoy’s solution can be considered a treatment option capable of reducing the recurrence rate of OKC in the maxillae.

Keyword

Adjuvant chemotherapy; Odontogenic cysts; Prognosis

Figure

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  Fig. 1 Radiographs of Patient No. 1 (37-year-old male). A. A radiograph showing large radiolucent lesions on the left posterior maxilla and both posterior mandibles. B. A radiograph showing marsupialization to reduce size. C. A radiograph taken four years after surgery and showing no recurrence.

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  Fig. 2 Radiographs of Patient No. 3 (10-year-old female). A. A radiograph showing radiolucent lesions on both posterior maxillae (arrows). B. A radiograph taken six years after surgery, showing no recurrence.

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  Fig. 3 Radiographs of Patient No. 2 (10-year-old male). A. A radiograph showing a patient with odontogenic keratocyst (OKC) on the left posterior maxilla (arrow). B. A panoramic view after cyst enucleation and extraction of #27. C. A radiograph taken three years after surgery, showing an additional OKC on the right posterior maxilla (arrow). D. A radiograph showing no recurrence throughout the follow-up period of three years (mandible) and five years (maxilla).

Reference

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