Ameloblastoma is the most common benign odontogenic tumor with local invasion and high recurrence, which generally occurs in the jaw bones. Hypercalcemia is a common paraneoplastic syndrome that is commonly observed in patients with malignancies but rarely encountered in patients with benign tumors. Thus far, not many cases of ameloblastoma with hypercalcemia have been reported, and the pathogenic mechanism has not been studied in depth. This paper presents a case report of a 26-year-old male diagnosed with giant ameloblastoma of the mandible, accompanied by rare hypercalcemia. Additionally, a review of the relevant literature is conducted. This patient initially underwent marsupialization, yet this treatment was not effective, which indicated that the selection of the appropriate operation is of prime importance for improving the prognosis of patients with ameloblastoma. The tumor not only failed to shrink but gradually increased in size, accompanied by multiple complications including hypercalcemia, renal dysfunction, anemia, and cachexia. Due to the contradiction between the necessity of tumor resection and the patient\'s poor systemic condition, we implemented a multi-disciplinary team (MDT) meeting to better evaluate this patient\'s condition and design an individualized treatment strategy. The patient subsequently received a variety of interventions to improve the general conditions until he could tolerate surgery, and finally underwent the successful resection of giant ameloblastoma and reconstruction with vascularized fibular flap. No tumor recurrence or distance metastasis was observed during 5 years of follow-up. Additionally, the absence of hypercalcemia recurrence was also noted.

BACKGROUND: Nasal vestibular cyst is a non-dental cystic mass that occurs under the skin at the base of the nasal vestibule. The primary treatment is a transnasal endoscopic excision of the cyst wall at the base of the nose to open the cyst wall at the base of the nasal cavity, namely, marsupialization.
METHODS: We present a patient with bilateral nasal vestibular cysts with sinus tract formation. This patient underwent marsupialization under general anesthesia because of the presence of facial swelling and other symptoms.
RESULTS: After a 4-year follow-up, our studied case show a significantly improved radiological outcome and clinical prognosis.
CONCLUSIONS: Compared to unilateral lesions, bilateral nasal vestibular cysts are more likely to be underdiagnosed due to the deceptive nature of the bilateral anatomy observed from the radiological findings. With this rare clinical case reported in this study, we hope our experience in diagnosis and treatment will provide a reference for otolaryngologist surgeons managing similar patients.

Jaw cyst is the most common pathology in the oral and maxillofacial region. The management of the teeth involved in cystic lesions is highly controversial. However, if the teeth involved in the cystic lesion could be preserved with their pulp vitality, the life span of these teeth will be considerably lengthened to improve the masticatory function of these patients after surgery. The present retrospective study over 10 years; with 92 patients that had cystic lesions of the jaws aimed to evaluate the effect of marsupialization on the preservation of the vitality teeth involved in the cystic lesion before and after treatment taking.
clinical retrospective study between January 2013 and January 2022, included 92 patients with a cystic lesion of jaw treated by marsupialization were carried out. The clinical data were collected; the number of teeth involved in the cystic lesion, the vitality of these teeth before and after marsupialization, the number of teeth that have undergone root canal treatment, the number of cases of failure (teeth that were extracted during surgery to open the cystic lesion and teeth that were extracted after surgery) as well as the duration of treatment for each patient were assessed.
Of 92 patients, 54 were men and 38 women with ages ranged from 7 years to 62 years were enrolled in this study.380 teeth were involved in the cystic lesion of that 352 teeth were positive and 28 teeth were negative before marsupialization. 28 teeth underwent root canal treatment before surgery. After surgery, 338 teeth were positive and 42 were negative. Among the 42 negative teeth, 31 teeth failed (extracted) and 11 teeth recovered their vitality before the end of the treatment.321 teeth were saved and preserved their pulp vitality.
The effect of marsupialization is good; it saves and preserves the vitality of the teeth involved in the cystic lesion and it reduces the cost of treatment for the patients.

Unicystic ameloblastoma (UAM) in the pediatric population is a rare clinical entity that has not been well addressed in the literature. Radical approaches affect a growing young patient\'s physical and psychological development, so conservative approaches are widely used for management in children. This report describes the case of a 9-year-old girl with UAM of the mandible, which also involved the impaction of the first and second premolars. Marsupialization with orthodontic treatment was performed to shrink the lesion and upright the first premolar involved in the tumor. Ten months after marsupialization, the lesion had healed entirely. The combination of conservative surgery and orthodontic treatment effectively shrank the lesion, preserving mandibular growth, preserving the involved first and second premolars, and promoting the eruption of the teeth.

This paper is to explore the effectiveness of a new modified transnasal endoscopic marsupialization through Nd:YAG (neodymium: yttrium-aluminum-garnet) laser in treating nasolabial cysts in office. A prospective study was undertaken. Patients who suffered from nasolabial cysts from April 2016 to May 2017 at our hospital were involved. They were all treated with Nd:YAG laser transnasal endoscopic marsupialization. All patients were treated in the outpatient treatment room under local anesthesia. The patients ranged in age from 27 to 82 years, with an average age of 45 years. We made the diagnosis by the anatomical site, radiological imagings, and histopathology of the cyst. A total of 12 consecutive patients (men, n = 2; women, n = 10) with nasolabial cysts were involved in this study. Of the 12 patients, 6 were on the left and 8 were on the right side, and 2 had bilateral nasolabial cysts. All patients returned to clinic at 1, 6, and 36 months after treatment. At the follow-up time, none of the patients has mucus accumulation in the sinus or cyst recurrence, except for one patient who received treatment twice. No complications and recurrence during follow-up. In this study, we find that transnasal endoscopic marsupialization through Nd:YAG laser in treating nasolabial cysts is relatively effective, especially for patients who do not want to be hospitalized or treated under general anesthesia.

OBJECTIVE: The aim of this study was to investigate the feasibility of intranasal endoscopic microwave ablation (MWA) on the management of postoperative ethmoid sinus mucoceles.
METHODS: The patients with postoperative ethmoid sinus mucoceles were ablated through intranasal endoscopic MWA. Postoperative pain intensity was measured via visual analogue scale (VAS), post-operative complications were recorded.
RESULTS: Of the 26 patients with unilateral postoperative ethmoid sinus mucoceles, the mucoceles were diagnosed 3 to 11 years with average time of time of 6.9 ± 2.7 years after endoscopic ethmoidectomy. The ipsilateral middle turbinate was present and intact in 24 patients and partially resected during the original surgery in the remaining 2. There were adhesions in the middle meatus in one case. All 26 patients were successfully treated with the intranasal endoscopic ablation technique in outpatient. The ablation time was 6 to 11 min, with an average duration of 6.84 ± 1.27 min. The mean VAS pain score was 2.41 ± 1.22. There were no perioperative complications reported in this series. No evidence of recurrence was observed in any patients during follow-up periods.
CONCLUSIONS: The present study demonstrates the safety and efficacy of intranasal endoscopic MWA in the office. The procedure is well tolerated by patients with low complication rates. Thus, it is alternative to conventional endonasal endoscopic marsupialization for treatment of postsurgical ethmoid sinus mucoceles.

Unicystic ameloblastoma is a unique histopathological type of ameloblastoma, and treatment is controversial. Marsupialisation is effective in reducing the size of cystic lesions and their complications. We have retrospectively analysed the clinical, histopathological, and prognostic data of affected patients who were treated by marsupialisation between 2003 and 2013 in three Chinese hospitals. Our aim was to evaluate the effects and prognosis, and the factors associated with outcome. A total of 116 patients with mandibular unicystic ameloblastomas were included, and 74, 26, and 16 patients were histopathologically classified as being luminal, intraluminal, and mural subtypes, respectively. Most responded well to marsupialisation, with an overall recurrence rate of 12%. Resorption of the root (p<0.001), perforation of the cortical bone (p=0.005), and histopathological subtype (p=0.013) were the main factors that predicted the outcome. Perforation of the cortical bone was the only reliable predictor of recurrence (p<0.001). Disease-free survival function curves indicated that patients with the mural subtype were at a higher risk of recurrence than patients with the other two subtypes (p=0.003). Poor outcomes of marsupialisation were treated surgically and, to date, no subsequent recurrences have been reported. Marsupialisation is effective for these patients, with a recurrence rate similar to that of radical treatment. The outcomes can be predicted using characteristics of the lesion such as resorption of the root, perforation of the cortical bone, and histopathological subtypes. However, additional studies are required to corroborate these findings.

The purpose of this study was to report the clinical efficacy of decompression for 3 cases with large periapical lesions and to review technique details. Three cases with large periapical cystic lesions were treated with decompression after root canal treatment. A traditional decompression technique was used for the first case. After aspiration, mucogingival incision, irrigation, and incisional biopsy, a pediatric endotracheal tube was sutured in place and kept for 3 weeks for lesion debridement. An aspiration/irrigation technique was adopted for the second case. An 18-G needle with a syringe was used to aspirate the cystic lesion. Two needles were then inserted into the lesion; copious saline irrigation was delivered from 1 needle and until clear saline was expressed from the other. For the third case, decompression was accomplished with a surgical catheter that was subsequently replaced with a gutta-percha plug after 1 month. None of the 3 cases underwent complete enucleation and root-end surgery. Healed lesions or lesions in healing were observed after 1 to 2 years. Based on the presented cases and published case reports on decompression, a literature review was provided covering indications, technique details, modification, and prognosis of decompression in endodontics. For large periapical cystic lesions, conservative decompression may be used for certain cases before or in lieu of apical surgery. Decompression enables healing of large, persistent periapical lesions after root canal treatment.

This retrospective study investigated the reduction rate and speed of shrinkage after marsupialization in mandibular cystic ameloblastoma and clarified whether marsupialization is appropriate for unicystic ameloblastoma and multicystic ameloblastoma.
Sixty-three patients with mandibular cystic ameloblastoma were initially treated with marsupialization. Premarsupialization and postmarsupialization panoramic radiographs were reviewed for reduction rate and speed of shrinkage, and then were evaluated with age, sex, tumor location, and tumor type.
The overall recurrence rate was 4.5% (2/44). The average reduction rate after marsupialization was 65.6%. No significant difference was found between unicystic ameloblastoma and multicystic ameloblastoma in reduction rate. The speed of shrinkage of unicystic ameloblastoma was significantly faster than that of multicystic ameloblastoma (P < .05). Similarly, patients with multicystic ameloblastoma had longer marsupialization periods than those with unicystic ameloblastoma (P < .05).
Marsupialization is effective in reducing tumor size for both unicystic ameloblastoma and multicystic ameloblastoma. Marsupialization plus second-stage curettage is recommended as the primary treatment for mandibular cystic ameloblastoma.

Previous published studies fail to present any consensus on a uniform treatment protocol for keratocystic odontogenic tumour (KCOT). Optimal management for KCOT was investigated by comparing the treatment outcome of marsupialization to the enucleation and radical resection. An online electronic databases search was carried out through the PubMed, Embase and Web of Science. The statistical analysis was performed by RevMan version 5.2. Fourteen eligible studies were identified for analysis. Fourteen studies evaluated included 938 patients, of which 853 underwent enucleation alone or plus adjunctive therapy, 110 underwent marsupialization with or without secondary adjunctive therapy, and 86 underwent radical resection alone. The marsupialization was significantly associated with lower recurrence compared to enucleation and resection in KCOT treatment (RR = 0.56, 95% CI 0.4-0.78, P = 0.0006 and RR = 0.32, 95% CI 0.15-0.69, P = 0.004, respectively). The results suggest that the marsupialization reduce the recurrence of KCOT better than enucleation and surgical resection and it may be the optimal approach for KCOT treatment.