Two-Stage Decompression by Delayed Enucleation in the Management of an Odontogenic Keratocyst in a Resource Limited Setting: A Case Report

Abstract

Introduction: Odontogenic keratocyst (OKC) is a rare type of developmental cyst known for its aggressive behavior and high recurrence rate. It arises from remnants of the dental lamina within the mandible and maxilla. Diagnosis is typically based on clinical, radiographic and histopathological findings.

Case Presentation: An 8-year-old male child was diagnosed with odontogenic keratocyst after a thorough clinical and radiological evaluation. The pertinent clinical findings included swelling in the anterior mandible, obliteration of the vestibule, and destruction of the buccal cortical bone. The panoramic X-ray revealed a well-defined radiolucent area in the anterior mandible.

Clinical Discussion: Treatment consisted of decompression with a tube in situ followed by delayed enucleation as definitive management. This resulted in significant clinical and radiographic improvement of the affected mandible.

Conclusion: Cystic decompression with a tube in situ for continuous irrigation followed by conservative enucleation represents an effective treatment approach for odontogenic keratocyst particularly in younger patients.