Cyst removal

[MichaelB]

Hi all,

I am due for the removal or drainage of a cyst (~ 2 x 2cm) in my lower left jaw. I can touch and move it somewhat from the outside so I am unsure if it is really in the bone.

I am scared of dental work and I went three weeks ago the first time in fifteen years. I found a very nice and understanding dentist. I had a cleaning done in the last 2 sessions I had with her and I already feel much better than ever.

I did a panoramic x-ray last week and besides the cyst (which is in front of two tooth ruins which need removal too) I need 2 other teeth extracted (stumps also) in the right lower jaw and another stump in my left upper jaw.

I am waiting for her response since she needs to consult with a specialist how best approach the cyst treatment.

They offer IV sedation also.

Next Friday I am due for the removal of the 2 stumps in my right jaw. She said IV sedation would not be necessary for that, just LA.

Since I have more treatments coming up I asked myself if it not all can be done in one session under IV sedation. Or would that be too much together: 5 extractions + cyst treatment?

 

[MichaelB]

I forgot to mention that we had problems to numb the side where the cyst is located while I had the session to clean my teeth. It needed twice the LA as on the opposite and was wearing off much faster than on the other side... Which scares me imaging treatment on that cyst and having LA wearing off...

 

[Gordon]

Sorry for being thick, I'm having some trouble working out what it is you're asking about, could you rephrase it a bit for me?

 

[MichaelB]

Sorry for being thick, I'm having some trouble working out what it is you're asking about, could you rephrase it a bit for me?

Hi, thanks for answering that fast. Sorry I am confused and it is a confusing story...

I went the first time in 15 years to the dentist. X-ray was done because I have a swelling in my lower jaw. We think it is a cyst. Any further treatment is on hold now until I had another consultation with my dentist and the surgeon.

Meanwhile my dentist consulted with the maxillofacial surgeon. Today my dentist called me and told me that the surgeon will see me to do further tests to establish what I really have there. Well, without that he saw me in person and only based on my X-ray he is already doing diagnoses, talking about titanium plates, general anestesia and that it would involve a stay in the hospital...

I'm getting a little bit suspicious now... They told me I have to take care, it has to be done soon, my next bite on something strong could break my jaw? ( I am eating, chewing normal, I don't feel like anything in my jaw is unstable).

My first questions are:

How sudden can a cyst appear or grow that big that a swelling in the face occurs? I don't remember having it around 9 month back... and now it is around 2 x 2 cm.

Can the surgeon tell from a simple x-ray if it is a tumor, an Ameloblastoma or "only" a cyst?

Or if the round thing you see on the x-ray is the cyst or a hole in the jaw?

I am in the Dominican Republic, I am German native, 47 y/o, male.

Please, I need to clarify some things here and I hope you can help me to do that.

 

[Kim]

Bless you, I cannot answer your questions, and because there must be some time differences between where you are and where Gordon is (Bonny Scotland) he went off line, hopefully someone else who is in the 'know' will pick up on this and be able to answer you.

Take care.

Kim

 

[MichaelB]

I got the X-ray forwarded from my dentist. I was trying to send it in a PM to Gordon, but it doesn't allow attachments?

It contains my name so I don't like to post it just like that...

Any idea?

 

[MichaelB]

That's a good sign, one of my best friends is from Scotland!

Bless you, I cannot answer your questions, and because there must be some time differences between where you are and where Gordon is (Bonny Scotland) he went off line, hopefully someone else who is in the 'know' will pick up on this and be able to answer you.

Take care.

Kim

 

[letsconnect]

Yes unfortunately, vBulletin doesn't allow attachments in PMs (though there might be plug-in available ). You could e-mail the file/s to [email protected] if you like and they can be passed on to him?

 

[Gordon]

Thank you Let's for forwarding the x-ray. It's very helpful.

I hate to break this to you, but you have 2 cysts, one on each side.

How soon can the surgeon see you? This needs sorted out very quickly, the bone destruction on the left side is very severe and if you aren't very careful your jaw will break. Hence the titanium plates warning. You need to get to hospital as soon as you can and get this taken care of. Be very careful when eating and stick to a soft diet eaten gently.
The cyst has been there for months, more likely years, do you see the way the teeth on either side of the cyst are displaced?
You can't really tell from the x-ray what kind of cyst it is, but from the position of it then it's probably a radicular cyst but a biopsy is indicated.

Please stop messing around with this and get it properly treated as soon as you possibly can.

I hope this helps and I don't want you to panic but please take this very seriously indeed.

Auf wiederhoren,

Gordon

 

[MichaelB]

Can't this be done by starting with draining the cysts? I've read about a procedure to insert a tube to relief pressure and let it hopefully become smaller with the time...

Problem is I can't afford to stay in a hospital merely because I could loose my job (working as a freelancer).
If this happens I would be without money for any further treatment also I have a family to feed and can't risk loosing my job...

If surgery, about how many days recovery / stay in hospital we are talking here? (I work from home so no commuting and such, so if it is only a couple days in Hospital I think I could manage...)

Thank you

I am waiting for an appointment for evaluation with the surgeon.

Could that be done ambulant with IV?

 

[MichaelB]

Now I found it:

Treatment of a Large Maxillary Cyst with Marsupialization, Decompression, Surgical Endodontic Therapy and Enucleation

I wonder, why this is not being considered by the surgeon... All what he said to my Dentist what has to be done is taking it out right away... Marsupialization was not mentioned.

"Hence the titanium plates warning." NO warning, he said already to my Dentist it HAS to be DONE without I had any consultation so far with him. That's what makes me scared.

 

[tabatha7]

Oh Michael... I do hope you can get this taken care of very soon. It would be best to contact an oral surgeon or hospital and ask them that question about draining the cysts. Gordon would not have told you what he did if it were not very serious. It sounds like time is of the essence. If you let it go too long and your jaw breaks then that would probably be an ever bigger expense. I hope you can have this done with minimal invasiveness but whatever you have done please do it quickly. If you don't trust the os shop around quickly and find someone who can help you. Wishing you all the best and praying for a good outcome.

 

[MichaelB]

I will ask the surgeon if this treatment is possible when I have my appointment. Maybe he can do it that way.If he say he cannot I will try to get a second opinion from another one. Well, if there is another one, we don't have too many specialists like that here around and my Dentist told me he is the best...

I am looking forward to have it done after X-mas. Funny I always was hoping I can get my dental needs done under GA... Guess what? Now when I can I am getting scared of the GA, lol....

Yes, I listen to what Gordon recommends, I've read many threads before I decided to get in touch and he gives the best advice!

Just was on the phone with my dentist. It appears there was a little misunderstanding from my side. Because of the GA and safety it has to be done in a Hospital, it doesn't mean I will be hospitalized for days... It starts to sound better...

Oh Michael... I do hope you can get this taken care of very soon. It would be best to contact an oral surgeon or hospital and ask them that question about draining the cysts. Gordon would not have told you what he did if it were not very serious. It sounds like time is of the essence. If you let it go too long and your jaw breaks then that would probably be an ever bigger expense. I hope you can have this done with minimal invasiveness but whatever you have done please do it quickly. If you don't trust the os shop around quickly and find someone who can help you. Wishing you all the best and praying for a good outcome.

 

[tabatha7]

No, it doesn't necessarily mean you will be in the hospital for days. It just means that because you are having general anesthesia it has to be in the hospital where you will be monitored properly by professionals. I had general years ago with a gall bladder surgery and you really don't know a thing. You just go to sleep and it's like taking a nap without dreaming. Atleast I didn't dream. It will all be over with before you know it. I hope you will come back and let us know how you are doing and everything. I will be praying for you for peace and for everything to go very well without being too invasive.

 

[Gordon]

Marsupialising is a possibility but it depends what kind of cyst it's discovered to be. It's not terribly pleasant for the patient afterwards because it's an unpleasant thing to have in your mouth. Does your work involve talking or just writing? Talking may be tricky for a few days to a week.

Please be very very careful when eating and for goodness sake don't take part in any sports, even a light tap in the wrong place will break your jaw! Make sure you keep your children and pets a safe distance away too.

Good luck with this and keep us posted.

 

[MichaelB]

I work from home, besides a weekly briefing there is no talking involved. Regarding food I was never a fan of the crunchy stuff so I take care. Sports atm I am with Winston Churchill regarding that

I very much hope I can get it done a Thursday or Friday and that I will be able to work the following Monday again...


Before the surgery, what they will do before they consider me able to get GA? I will have to do a health check or?

Another thing is I don't feel anything weak in my jaw, no pain, no pressure, no "egg shell crumbling sound" nada...

I hope they can take care of my teeth ruins on "top" of the cysts, they appear to have no more roots in the X-ray.

And I can't see any wisdom teeth, I think I don't have any....

I will for sure keep you updated here, to help others too with maybe a similar problem...

Thank you all!

 

[MichaelB]

Confused: Marsupialization and Cystostomy are the same?

 

[Gordon]

Well, I've only heard of cystostomy when it's used in connection with bladder surgery, but or than that they sound very similar

PreGA checks are normally height/weight/blood pressure/urine test and an ECG.

 

[MichaelB]

Yesterday I had an appointment with the surgeon. He checked me and told me my bone is still strong enough and unlikely to break yet but of course I have to be careful he told me.

Seeing me in person he changed his mind about doing it with GA and in Hospital. He also was open to do the decompression / draining but he said it would not be necessary since he still could remove the whole thing right away without problems. So, in January I will get my checkup and end of January he will do it in the location of my dentist with LA.

Glad it will be no hospital involved etc... BUT, now I am getting nervous since he needs to extract the 2 damaged teeth but also the molar to prevent the same thing happen again in a couple years...

I will be charged 2000 US$, a litle steep but 3 extractions and cyst removal is more expensive in the States I assume?

 

[tabatha7]

Michael, I am so relieved that you are getting this taken care of. I have prayed for you and am very glad you don't have to be hospitalized. Will be hoping everything goes well. Please keep us updated.