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      Accessory oral cavity

      case-report

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          Abstract

          This is a rare case report of a patient around 11 years with the complaint of extra mouth who reported to the hospital for removal of that extra mouth. On examination there was accessory oral cavity with small upper and lower lips, seven teeth and saliva was drooling out. Under general anesthesia crevicular incision from 32 to 43 was put and labial gingiva with alveolar mucosa was reflected completely and bone exposed to lower border of mandible. There were seven teeth resembling lower permanent anterior teeth in the accessory mouth, which was excised with the accessory lips. 41 extracted and osteotomy carried out extending the incision from the extracted site and osteotomy carried out. Dermoid cyst both below and above the mylohyoid muscle and rudimentary tongue found and excised and the specimen sent for histopathological examination. The wound was closed and uneventful healing noted to the satisfaction of the patient. This is a rare and interesting case which has been documented.

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          Most cited references19

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          Sublingual epidermoid cyst: a case report

          Epidermoid and dermoid cysts represent less than 0.01% of all oral cavity cysts. The cysts can be defined as epidermoid when the lining presents only epithelium, dermoid cysts when skin adnexa are found, and teratoid cysts when other tissue such as muscle, cartilage, and bone are present. In this article, we present the case of an epidermoid cyst, with an oral as well as a submental component, in an 11 year old boy who presented with complaints of a mass in the oral cavity, difficulty chewing and swallowing of solid foods for about 3 years. He was admitted to the otolaryngology department. On examination, a mass displacing the tongue superiorly and posteriorly was noticed. An MRI scan was done and showed a 40 × 35 mm well-circumscribed non-enhancing cystic mass extending from the sublingual area to the level of the thyroid notch. The content of the cyst was homogenous. On examining the neck, a firm swelling was also noticed in the submental area, extending down to the thyroid notch. Under general anesthesia and with nasotracheal intubation, the patient underwent surgical removal of the mass. Extraorally, a midline submental horizontal incision was performed through the mucosa overlying the swelling and the cyst was dissected from the surrounding tissues and removed. On histological examination, acidophilic stratum corneum and basophilic dot like staining of stratum granulosum, which is the hallmark of an epidermoid cyst, were seen. The patient did well postoperatively, and no recurrence was noticed at the 6-months follow-up.
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            Sublingual epidermoid cyst.

            Dermoid and epidermoid cysts are developmental pathologies that occur in the head and neck with an incidence ranging from 1.6 to 6.9%, and they represent less than 0.01% of all oral cavity cysts. Our purpose is to report a case of sublingual epidermoid cyst of the floor of the mouth. We studied and operated on an 18-year-old white male patient showing a large swelling of oral floor. His main symptoms were difficulty breathing, swallowing, and speaking. At his birth the patient's tongue was adherent to the floor of the mouth. His father had the same problem at birth. Both father and son underwent surgical separation of tongue, during the post-neonatal period. After the surgical removal of the swelling, under general anesthesia, all the patient's symptoms were missed. Histological examination of the mass confirmed the diagnosis of an epidermoid cyst. No relapse of the lesion was present in ten months of follow-up. Many theories are proposed on the etiology of the epidermoid and dermoid cyst. In this case a traumatic event can be found, such as an operation of the tongue in neonatal age. However a multifactorial origin must be assumed for justifying the fact that the patient's father did not develop a dermoid cyst although he had the same problem of an adherent tongue and was operated on.
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              Dermoid Cyst of the Floor of the Mouth

              Dermoid cysts of the floor of the mouth are rare lesions thought to be caused by entrapment of germinal epithelium during the closure of the mandibular and hyoid branchial arches. They usually present as a nonpainful swelling. This type of lesion occurs more frequently in patients between 15 and 35 years, but can be seen in all age ranges. Histologically, all dermoids are lined by epidermis. The contents of the cyst lining determine the histological categories of the cyst: epidermoid, if epidermis is lining the cyst; dermoid, if skin annexes exist; or teratoid, if there are tissues derivated from the three germinal layers. Anatomical classification is useful for surgical approach choice, intra- or extraorally. This report presents a case of a dermoid cyst of the floor of the mouth in a 12-year-old patient, and a review of all steps necessary for its diagnosis and treatment was made.
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                Author and article information

                Journal
                Natl J Maxillofac Surg
                Natl J Maxillofac Surg
                NJMS
                National Journal of Maxillofacial Surgery
                Medknow Publications & Media Pvt Ltd (India )
                0975-5950
                2229-3418
                Jul-Dec 2012
                : 3
                : 2
                : 232-237
                Affiliations
                [1]Consultant, Meenakshi Mission Hospitals and Research Centre (MMHRC), Madurai, Tamil Nadu, India
                [1 ]Ultra's Best Dental Science College, Madurai, Tamil Nadu, India
                [2 ]Surgeon ESI Hospital, Coimbatore, Tamil Nadu, India
                Author notes
                Address for correspondence: Dr. Usha Giridhar Varadarajan, C 72/44 Santanam Road, TVS Nagar, Madurai 625 003, Tamil Nadu, India. E-mail: giridhar.usha3@ 123456gmail.com
                Article
                NJMS-3-232
                10.4103/0975-5950.111395
                3700167
                23833508
                88e7f5ec-31f5-4778-bb8d-1bcfd7cd5e02
                Copyright: © National Journal of Maxillofacial Surgery

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Case Report

                Surgery
                accessory mouth,teratoma,osteotomy,accessory oral cavity,sublingual dermoid
                Surgery
                accessory mouth, teratoma, osteotomy, accessory oral cavity, sublingual dermoid

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