21046 Excision of benign tumor or cyst of mandible; requiring intra-oral osteotomy (eg, locally aggressive or destructive lesion[s])

Name of the Procedure:

Excision of benign tumor or cyst of mandible; requiring intra-oral osteotomy

• Common names: Jaw cyst or tumor removal, Mandibular tumor excision
• Technical/Medical term: Intra-oral osteotomy for mandibular benign lesion removal

Summary

This surgical procedure involves removing a non-cancerous growth or cyst from the lower jawbone (mandible). It requires cutting through the jawbone from inside the mouth (intra-oral osteotomy) to access and excise the lesion.

Purpose

The procedure is designed to address benign but potentially problematic growths in the jaw. The goal is to remove the lesion to prevent further complications, such as pain, infection, or damage to surrounding structures.

Indications

• Presence of a benign tumor or cyst in the mandible
• Symptoms such as pain, swelling, or difficulty in chewing
• Growths causing damage to teeth or jawbone
• Failure of non-surgical treatments

Preparation

• Patients may need to fast for several hours before the procedure.
• Medication adjustments, particularly blood thinners, under the guidance of a healthcare provider.

• Pre-operative imaging tests like X-rays or CT scans to evaluate the lesion.

  Procedure Description

  1. The patient is given anesthesia, typically local with sedation or general anesthesia.
  2. An intra-oral incision is made to access the mandible.
  3. The surgeon performs an osteotomy (cutting the bone) to reach the benign lesion.
  4. The tumor or cyst is carefully removed.
  5. The bone is repositioned and secured using special instruments or plates if necessary.
  6. The incision is closed with sutures.

Duration

The procedure typically takes 1 to 3 hours, depending on the lesion's size and complexity.

Setting

Usually performed in a hospital or surgical center, sometimes on an outpatient basis.

Personnel

• Oral and maxillofacial surgeon
• Surgical nurses
• Anesthesiologist

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma formation
• Temporary or permanent nerve damage causing numbness
• Fracture of the mandible
• Recurrence of the lesion

Benefits

• Relief from symptoms caused by the benign lesion.
• Prevention of further complications or structural damage.
• Improved oral function and appearance.

Recovery

• Patients may experience swelling and discomfort; pain management with prescribed medications is important.
• Soft food diet and avoiding strenuous activities for several weeks.
• Regular follow-up appointments to monitor healing.
• Complete recovery usually takes several weeks to a few months.

Alternatives

• Observation and regular monitoring for asymptomatic and non-aggressive lesions.
• Needle aspiration or biopsy for fluid-filled cysts.
• Non-surgical medication management, though limited in effectiveness for solid tumors.

Patient Experience

• The patient will be under anesthesia, so they will not feel pain during the procedure.
• Post-operatively, some pain and swelling are expected; medications and ice packs can help manage discomfort.
• Gradual improvements in symptoms should be noticed within a few weeks.