Treatment of jaw cysts with an irrigational method (II)

Abstract

Cysts in jaws are generally excised by Partsch II when they are small. When they are large, they are excised by Partsch I to form a paranasal sinus in an oral cavity, or by an operation based on Caldwell-Luc's method to form it from nostrils, as Partsch II forms dead space after the operation and the cyst increases by the pressure of intracystic fluid. However, with Partsch I, the bone needs many days to regenerate, and since a surgical ciliated cyst of the maxilla is often formed after an operation of the maxillary sinus, Partsch I is not necessarily a good method. Therefore, in order to control cyst inflammation, the irrigation of cyst cavities was repeated, as it is held that prostaglandin-like (PG-like) substances are generated in the cyst walls when a cyst is inflamed by bacterial infection; prostaglandin E₂ (PGE₂) especially acts on the resorption of bone and enlarges the cyst. As a result of repeated irrigations, infection of the cyst cavities disappeared simultaneously with decreasing the pressure of intracystic cavities, the values of thiobarbituric acid, Prostaglandin E, Prostaglandin F_2α (TBA, PGE, PGF_2α), and the free radical intensity at g=2.003 decreased. The bone regenerated around the cyst walls, and finally the cyst diminished in size. In the case of the viscous cyst fluids, a solution containing hyaluronidase enabled complete disappearance. It would be better to apply Partsch II after the cyst has become smaller through irrigation. After the irrigational method, irregular formation and tendency toward malignancy could be found in none of the cyst wall cells.