Figure - available from: Frontiers in Surgery
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Hematoxylin and eosin-stained section of the resected cyst (scale bar = 250 μm). (A, B) Show weakly and highly magnified images, respectively. The cyst was lined by a stratified squamous epithelium with dense lymphocyte infiltration and fibrous tissue under the epithelium.
Source publication
Nasopalatine duct cyst (NPDC) is the most common type of non-odontogenic cysts of the jaw. It has been treated with complete surgical resection using a sublabial or palatine approach. However, complete removal of the cyst can be accompanied by postoperative complications including oronasal fistula. Recently, endoscopic marsupialization for the dise...
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Citations
... Some lesions may have a heart-shaped appearance. 2 The cause of this lesion is uncertain, but some factors like prior trauma, poorly fitting dentures, local infection, genetic and racial factors have been suggested as possible causes. 7 Another theory is that these lesions arise from the spontaneous growth of embryonic tissue remnants. Most of these cysts are discovered accidentally and do not cause any symptoms. ...
... Symptoms such as pain, itching, ulceration, local infection, and/or fistulization are observed in such cases. 7 NDCs are almost three times more prevalent in men than in women, and Caucasians are more likely to develop NDCs. 8 Histologically, stratified squamous epithelium alone or in conjunction with respiratory-type epithelium lines the NDC. 2 In lesions that are close to the nasal cavity, a respiratorytype epithelium can be seen. ...
Introduction
Nasopalatine duct cyst (NDC) is the most prevalent non-odontogenic cyst emerging from the epithelial remnants in the maxillary incisive canal. A sublabial or transpalatal approach is performed to enucleate NDC completely. More recently, transnasal endoscopic marsupialization has been used gradually.
Case Presentation
A 24-year-old male patient with a large nasopalatine duct cyst with a diameter of 51 mm was managed by transnasal endoscopic marsupialization under general anesthesia. The presentation involves painless swelling around the left side of the anterior maxilla and bulging of the hard palate. No postoperative complications were observed after a 3-month follow-up. Transnasal endoscopic marsupialization is a minimally invasive surgery for large NDC.
Clinical discussion
Approximately 1% of the population has a nasopalatine duct cyst. Surgical treatment was carried out under general anesthesia; the cyst was dissected and removed using a typically transnasal endoscopic marsupialization technique.
Conclusion
The cause of the NDC is unclear. Simple surgical resection and clinical and radiological control are recommended to ensure the case is resolved correctly.
Nasopalatine duct cysts (NDCs) are relatively rare non-odontogenic cysts of the jaw, accounting for about 2–4% of all jaw cysts. Surgery is the first-line treatment for NDCs. Transpalatal or transgingival surgery is common for NDCs, but transnasal endoscopic surgery has recently been increasingly reported. We present a case of a 38-year-old man with an NCD in the median hard palate that was opened using endoscopic endonasal surgery. Endonasal endoscopy revealed raised lesions at the floor of the bilateral nasal cavities. Endoscopic transnasal surgery was performed from the right nasal floor, and the upper surface of the cyst was opened as wide as possible. After the operation, swelling of the bilateral nasal floor improved; and more than a year later, the cyst remained open and showed no malignant findings. There are several cases of NDCs complicated by malignancy. Therefore, it is important to follow the patient for a long period postoperatively. There are also several reports of surgery-related injury to the nasopalatine duct nerves and tooth sensory abnormalities; thus, surgical manipulation should be done carefully. Opening cysts by transnasal endoscopic surgery is less invasive than cystectomy by transpalatal or transgingival surgery. Our case suggests that transnasal endoscopic surgery can be very useful in cases of NDCs that do not show substantial components on imaging findings.
