Surgical Management of Odontogenic Keratocyst (OKC) with Chemical Cauterization Using Topical 5-Fluorouracil and Soft Tissue Reconstruction Using a Nasolabial Flap: A Case Report
Nishigandha Pawar *
Department of OMFS, C.S.M.S.S Dental College and Hospital, Chhatrapati Sambhaji Nagar, India.
Uma Mahindra
C.S.M.S.S Dental College and Hospital, Chhatrapati Sambhaji Nagar, India.
Lata Kale
Department of OMFS, C.S.M.S.S Dental College and Hospital, Chhatrapati Sambhaji Nagar, India.
Deepak Motwani
Department of OMR (Oral Medicine and Radiology) C. S. M. S. S. Dental College and Hospital, Chhatrapati Sambhaji Nagar, India.
Shailesh Agrawal
C.S.M.S.S Medical College Chhatrapati Sambhajinagar, India.
Zehra Nehri
Department of OMFS, C.S.M.S.S Dental College and Hospital, Chhatrapati Sambhaji Nagar, India.
Bapu Kendre
Department of OMFS, C.S.M.S.S Dental College and Hospital, Chhatrapati Sambhaji Nagar, India.
Yashashri Deshmukh
Department of OMR, C. S. M. S. S. Dental College and Hospital, Chhatrapati Sambhaji Nagar, India.
Shraddha Rasne
Department of OMFS, C.S.M.S.S Dental College and Hospital, Chhatrapati Sambhaji Nagar, India.
*Author to whom correspondence should be addressed.
Abstract
Aim: This case report evaluates the effectiveness of surgical enucleation with chemical cauterization using 5-fluorouracil (5-FU) and soft tissue reconstruction with a nasolabial flap in the management of odontogenic keratocyst (OKC).
Study Design: Case Report.
Place and Duration of Study: Department of Oral and Maxillofacial Surgery, C.S.M.S.S Dental College and Hospital, Chhatrapati Sambhajinagar, India with follow-up over 1.5 years.
Methodology: A 52 year female patient underwent surgical enucleation of the OKC, followed by chemical cauterization of the cystic cavity using 5% 5-fluorouracil (5-FU) to minimize recurrence. Postoperatively, soft tissue dehiscence was identified and managed with reconstruction using an inferiorly based nasolabial flap to restore the intraoral soft tissue integrity.
Results: The combined approach of enucleation, chemical cauterization with 5-FU, and nasolabial flap reconstruction resulted in successful management of the lesion, minimal recurrence risk, and satisfactory functional and aesthetic outcomes. Postoperative recovery with excellent healing observed in follow-ups over 1.5 year
Conclusion: Surgical enucleation with adjunctive 5-FU chemical cauterization is a promising method for reducing OKC recurrence. The nasolabial flap is a versatile and reliable option for reconstructing small-to-moderate intraoral soft-tissue defects, even in cases with postoperative complications.
Keywords: OKC, 5 Flurouracyl (5-FU), basal cell nevoid cacinoma syndrome, ptch gene, carnoys solution, nasolabial flap surgery, SMAS