Cyst Enucleation Revisited: A New Technical Modification to Ensure Complete Removal of Cystic Lining

Treatment modalities for cysts have evoked the greatest debates and controversies because of the size, localization, pathological formation and recurrence potential of cysts. Enucleation has been most effective and reliable method to treat cysts. It completely removes the cystic capsule, thus reducing the possibility of recurrence. Certain modifications to the method of enucleation have been proposed for ease of removal and to assure complete enucleation.

A new modification aimed at increasing the probability of a good and complete enucleation has been proposed at the Department of Oral and Maxillofacial surgery in DAV Dental College, Yamunanagar.

A window is created in the cystic roof with complete aspiration and evacuation of cystic contents following which the complete cystic lumen is packed with a ribbon gauze. The ribbon gauze is then wetted with normal saline or povidone iodine. Once enucleation is started at the correct plane, it gives a stable base from inside the cystic lumen due to which perforation of cyst is reduced markedly.

The newly proposed technique reduced the chances of cystic lining perforation and ensures the in toto enucleation of cysts in majority of the operated cases.