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9  Imaging of Orthognathic, Maxillofacial, and Temporomandibular Joint Surgery

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9.11\ Cyst Decompression

9.11.1\ Discussion

Decompression with stenting can be used to treat large mandibular cysts (Fig. 9.22). The stents typically remain in position for about

a

6–8 months, at which point the cysts decrease in size on average by 80%. The procedure consists of unroofing the cyst, irrigating the cyst cavity. The stents are inserted in the cavity and secured by the overlying mucosa and sutures. The stent appears as a high-attenuation tubular structure on CT.

b

Fig. 9.22  Cyst drainage. Panoramic radiograph (a) in a patient with a right mandibular angle dentigerous cyst treated with fenestration and stent decompression (arrow).

Axial image (b) in a different patient with a history of odontogenic keratocyst shows a stent (arrow) within a right mandibular cyst cavity