J Korean Assoc Oral Maxillofac Surg.  2024 Aug;50(4):197-205. 10.5125/jkaoms.2024.50.4.197.

Three-dimensional analysis of decompression efficacy and influencing factors in the maxillofacial cystic lesions: a retrospective study

• Kim HY
• Lee SM
• Park JH
• Kim SJ

• KMID: 2559266
• DOI: http://doi.org/10.5125/jkaoms.2024.50.4.197

Abstract

Objectives
To evaluate the effectiveness of decompression and various parameters that may affect volume change in cystic lesions.
Patients and Methods
This retrospective study included patients who visited the Department of Oral and Maxillofacial Surgery at Ewha Womans University Medical Center between 2012 and 2022 for decompression of cystic lesions of the jaw. To measure volume changes, pre- and post-decompression cone-beam computed tomography was performed and reconstructed in three dimensions using Mimics 25.0 software (Materialise NV). A comparative analysis was performed based on sex, age, initial cyst volume, location, degree of cortical layer expansion, and pathologic diagnosis using the Mann–Whitney U and Kruskal–Wallis tests.
Results
In all 20 cases, the duration of decompression was 7.84±3.35 months, and all patients successfully completed the decompression period without any complications. Significant differences were observed in the reduction rate and shrinkage speed based on the degree of cortical layer expansion. However, only the shrinkage speed (not the reduction rate) showed a significant difference with respect to the initial cyst volume. Significant differences were not observed based on sex, age, location, or pathologic diagnosis.
Conclusion
Although the present study involved a small number of cases, the effectiveness of decompression was confirmed. In particular, 3D analysis overcame the shortcomings of previous studies of decompression and allowed earlier resection. Further studies with more patients are required to provide a rationale for these results and identify factors that influence decompression.

Keyword

Decompression; Odontogenic cysts; Cone-beam computed tomography

Figure

• 

  Fig. 1 A case involving catheter placement for decompression. A. Intraoral view after catheter placement for decompression. B. Obturator produced with acrylic resin and a catheter.

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  Fig. 2 Coronal and sagittal cone-beam computed tomography performed at follow-up after decompression; cystic lesion size decreased over the course of approximately 11 months. A. At initial diagnosis. B. Five months after decompression. C. Eleven months after decompression.

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  Fig. 3 Cystic lesion analysis in cone-beam computed tomography images. Three-dimensional reconstruction for volume measurement.

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  Fig. 4 Histopathologic changes due to decompression. A. Before decompression of an odontogenic keratocyst (H&E staining, ×200). B. After decompression with resection (H&E staining, ×100). C. Before decompression (H&E staining, ×40) of a dentigerous cyst. D. After decompression with resection (H&E staining, ×40).

Reference

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