A man in 5th decade of life complained of a huge odontogenic tumor, diagnosed as Adenomatoid Odontogenic Tumor sought removal of the lesion. His concern was post-operative defect and preferred not to have a scar in his face. The size of the tumor can be appreciated in the CT scan while OPG would show the shifting of the teeth due to tumor.
The treatment plan was to remove the entire tumor with adequate marginal clearance through his mouth thereby avoiding unsightly scar. A gingival crevicular incision was placed along the entire length of the tumor exposing the entire tumor.
An appropriate plane of cleavage was identified and the tumor was completely isolated by blunt incision. To facilitate and minimize post-operative defect,preservation of mucosa was desired. This would also prevent formation of fistulas and also help in proper feeding and speech.
The tumor was slowly mobilized in segments and the tumor was removed as a full mass. The margins were trimmed and the sinus lining was cleaned. The sharp bony margins were trimmed.
The defect was stuffed with cotton gauze dipped in Betadine. One free end of the gauze was retrieved through the nares, so that it could be removed three days latter. The mucosa was closed in layers. The gauze ensured prevention/ accumulation of blood as also reduced the chance of hematoma. Three days after, the gauze was removed.
The correction of the defect could be appreciated in the post operative image.
The treatment plan was to remove the entire tumor with adequate marginal clearance through his mouth thereby avoiding unsightly scar. A gingival crevicular incision was placed along the entire length of the tumor exposing the entire tumor.
An appropriate plane of cleavage was identified and the tumor was completely isolated by blunt incision. To facilitate and minimize post-operative defect,preservation of mucosa was desired. This would also prevent formation of fistulas and also help in proper feeding and speech.
The tumor was slowly mobilized in segments and the tumor was removed as a full mass. The margins were trimmed and the sinus lining was cleaned. The sharp bony margins were trimmed.
The defect was stuffed with cotton gauze dipped in Betadine. One free end of the gauze was retrieved through the nares, so that it could be removed three days latter. The mucosa was closed in layers. The gauze ensured prevention/ accumulation of blood as also reduced the chance of hematoma. Three days after, the gauze was removed.
The correction of the defect could be appreciated in the post operative image.
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