9.10\ Enucleation

9.10.1\ Discussion

Enucleation of tumors and cysts can produce irregular margins and periosteal reaction that appears aggressive and can resemble infection of tumor recurrence/progression (Fig. 9.21). Sometimes the cavities are filled with bone graft material. Nevertheless, healing and spon-

a

taneous filling of the residual cavities have been reported to occur in all cases of uncomplicated mandibular cyst enucleation. In particular, the cavities generally decrease in size by over 80% by 24 months. Similarly, bone density increases by over 90% by 24 months on average. Complications of these procedures include tumor recurrence or seeding, injury to the inferior alveolar nerve, osteomyelitis, and soft tissue­ infections.

b

Fig. 9.21  Enucleation. The patient has a history of brown tumor of the mandible. Sagittal CT image obtained 3 weeks enucleation (a) shows a defect in the right

mandibular­ body (arrow). Sagittal CT obtained 3 months later (b) demonstrates interval healing of the defect (arrow)