Successful removal of sizable odontogenic keratocyst and reconstruction of lower jaw

Preoperative 3DCT scan showing huge radiolucent lesion involving the entire ramus and angle of the mandible (right side)

A 13 year old girl from Manipur was brought to our hospital by her parents seeking the best treatment for facial asymmetry. The girl initially presented with a complaint of huge swelling in the right side of the face which was increasing in size. The parents were greatly worried about their daughter’s present condition.

Through clinical and radiological investigations revealed a large radiolucent lesion involving the entire ramus and angle of the mandible extending to the lateral side of lower right first molar teeth. Biopsy of the lesion confirmed the lesion to be odontogenic keratocyst. The parents were explained that the facial asymmetry was only due to the cystic contents.

Maxillofacial Surgeon Dr.S.M.Balaji planned to do segmental mandibulectomy followed by reconstruction with rib graft. Dr.S.M.Balaji successfully removed the cyst completely along with the affected bone and teeth. Rib graft was harvested and used to reconstruct the jaw bone defect and the surgical site was closed. After subsequent healing, implants & ceramic crowns will be placed for permanent replacement of lost teeth.

Preoperative 3DCT scan showing huge radiolucent lesion involving the entire ramus and angle of the mandible (right side)
Pre-operative image showing huge swelling in the right side of the face
Costochondral rib graft harvested to reconstruct the affected portion of mandible
Cystic lesion along with the affected bone and teeth removed in toto
Harvested rib graft used to reconstruct the defective portion of mandible
Immediately after suturing Extraoral view
Immediately after suturing Intraoral view
smbalaji:
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