During treatment of KCOT using either enucleation with or without ajuvant therapy or marsupialization with or without residual cystectomy, some authors advocate that excision of the overlying mucosa is necessary to eliminate epithelial and micro cysts with subsequent reducing recurrence?
Excision of overlying mucosa can contribute remarkably to reducing recurrence rate of KCOT however, that should not be considered a general rule. Each case should be taken on it's own merit. A lesion that is completely within the cancellous space of bone, distant from the bucal or lingual plates of bone (In the mandible for example) should not require such excision. On the other hand, a lesion that has come very close to the labial or lingual plate or has even perforated the plate would benefit from such excision. These are two extremes of the situation. You can be sure there will be the dicey cases with which you have to weigh the sides carefully or engage the use of frozen section.
Absolutely agree with Dr Oginni, I try to perform enucleation and marsupialization at the same time.
I do agree with excision provided its very near to or attached to overlying mucosa otherwise it is better to keep mucosa intact
Yes, better we excise the overlying mucosa especially in multi locular kcot which helps in avoiding recurrence
We have conducted a sysytematic review and meta anlysis to address this issue
Please see the below link:
http://www.joms.org/article/S0278-2391(16)30033-7/abstract
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