Traitement des kystes, tumeurs et pseudotumeurs bénignes des maxillaires

Although maxillary and mandibular cysts and benign tumours are very different with regard to their aetiology, diagnosis and evolution, they have in common to need surgical treatment as they are infected or so voluminous that they lead to dysfunction, dysmorphism and fracture risk. A first biopsy decision is a mistake because of the dissemination risk and the induced swelling reaction which could interfere with the future ablation and the definitive histological analysis. Of course, a reliable histological result takes advantage of a macroscopic, microscopic and ultrastructural analysis on the complete surgical piece. Also, the discovery of such a tumour will lead the clinician and the surgeon to a rigorous diagnosis estimation, taking into account both clinical and radiographic argues: the patient age, the lesion localisation, the evolution, the relation of the tumour with the teeth and cortical bone. This estimation will allow the surgeon to decide the best surgical preserving treatment before receiving the definitive histological result. In most of the cases, a benign tumour, even though voluminous, should be surgically removed taking care of the strong mucous and periosseous membrane. In few cases, tumoural extension in peripheral tissues imposes radical bone and muscular enlarged resection followed by a reconstructive method.