Surgical Care

Nasopalatine duct cysts are treated by enucleation via a palatine or buccal approach; transnasal endoscopic marsupialization can also be applied.^{[56, 57]}

Recurrence is uncommon, having been reported in 0-11% of patients.^{[5, 6, 7]}

If components of the long sphenopalatine nerve are removed during surgery, it may cause paresthesia to the anterior palate.^{[34, 7]}

Complete bone regeneration within the bony defect is expected postoperatively.

In some cases, a marsupialization is necessary, such as when the capsule shows adhesion with the surrounding area and enucleation is difficult to perform.

Complications

Very large, untreated nasopalatine duct cysts may resorb the roots of the adjacent teeth and display the roots. Other complications may include perforation of the vestibular bone, nasal cavity, and maxillary sinus^[58]; a large cyst can cause complete destruction of the anterior palate and pyriform rim.^[59]Paresthesia to the anterior palate may occur in 10% of cases if components of the long sphenopalatine nerve are removed or damaged during surgery.^{[28, 34, 7]}In addition, devitalization of central incisors, postoperative wound infection, and postoperative fistula can occur.^[12]There is a statistically significant correlation between the presence of postoperative and late complications with cyst diameter, surface area, and volume.^[52]

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Media Gallery

An ovoid radiolucent area between the central incisor teeth with a poorly defined sclerotic outline can be suspected to be a cyst.
An ovoid, clearly radiolucent area with a sharply defined outline and sclerotic margin that has a bearing on the teeth appendix; secondary draw aside of incisor roots.
An ovoid radiolucent area with a poorly defined sclerotic outline between the central incisor teeth.

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Author

Piotr Kurnatowski, MD Professor, Department of Otolaryngology, Medical University of Lodz, Poland

Disclosure: Nothing to disclose.

Coauthor(s)

Deborah Cleveland, DDS Director of Oral Pathology, Associate Professor, Department of Oral Pathology, Biology and Diagnostic Sciences, Rutgers New Jersey Medical School

Deborah Cleveland, DDS is a member of the following medical societies: American Academy of Oral and Maxillofacial Pathology, South Dakota State Medical Association, Teratology Society, Texas Orthopaedic Association, Wisconsin Medical Society, Southeastern Dermatological Association, Southeastern Society of Plastic and Reconstructive Surgeons, Southeastern Surgical Congress, Southern Oncology Association of Practices, Southern Clinical Neurological Society, Southern Medical Association, Southern Orthopaedic Association, Southern Society for Pediatric Research, Southern Thoracic Surgical Association, Southwest Pediatric Nephrology Study Group, SWOG, Southwestern Surgical Congress, Special Operations Medical Association, Swedish Medical Association, Sydenham Society, Tennessee Medical Association, Tennessee Radiological Society, Texas Medical Association, Texas Pediatric Society, Texas Society of Plastic Surgeons

Disclosure: Nothing to disclose.

Camila K Janniger, MD Clinical Professor of Dermatology, Clinical Associate Professor of Pediatrics, Chief of Pediatric Dermatology, Rutgers New Jersey Medical School

Camila K Janniger, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Military Dermatologists, Phi Beta Kappa, Texas Dermatological Society

Disclosure: Nothing to disclose.

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Professor of Pediatrics, Professor of Medicine, Rutgers New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, New York Academy of Medicine, Royal College of Physicians of Edinburgh, Sigma Xi, The Scientific Research Honor Society

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Jacek C Szepietowski, MD, PhD Professor, Vice-Head, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University; Director of the Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Poland

Disclosure: Received consulting fee from Orfagen for consulting; Received consulting fee from Maruho for consulting; Received consulting fee from Astellas for consulting; Received consulting fee from Abbott for consulting; Received consulting fee from Leo Pharma for consulting; Received consulting fee from Biogenoma for consulting; Received honoraria from Janssen for speaking and teaching; Received honoraria from Medac for speaking and teaching; Received consulting fee from Dignity Sciences for consulting; .

Nasopalatine Duct Cyst Treatment & Management

Surgical Care

Complications

References

Tables

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