Anesthesia Management of an Anxietic Patient with Huge Odontogenic Keratocyst

Öz

Odontogenic keratocyst (OKC); is a developmental benign, locally aggressive odontogenic cyst originating from remnants of the dental lamina or the basal cells from the oral epithelium. OKC affects the mandible more often. Most lesions are located in the posterior mandible and generally occur at the angle, show a predominant mesio-distal expansion.Due to local aggressive propagation, internal growth potential and satellite cysts being prone to recurrence, it was named as ‘keratocystic odontogenic tumor’ between 2005-2017, and was evaluated in the class of neoplasm but is stil included in the classification of cysts. In this case report, we wanted to talk about the anesthetic management of an anxiety patient who was previously operated under local anesthesia, and local anesthesia could not be achieved due to the chronic infection and the location of the lesion.

Anahtar Kelimeler

• Odontogenic keratocyst, anesthesia, sedation, Gow-Gates, biopsy

Anksiyetik Hastada İleri Boyutlardaki Odontojenik Keratokist İçin Anestezi Yaklaşımı

Öz

Odontojenik keratokist (OK); ağız epitelinin bazal hücrelerinden veya dental lamina artıklarından meydana gelen gelişimsel, benign, lokal agresif davranışta bir odontojenik kisttir. Mandibulada daha sık görülmektedir. Lezyonlar sıklıkla posterior mandibular angulusta görülmekte ve mezio-distal yayılım göstermektedir. Lokal agresif yayılımı, internal büyüme potansiyeli ve uydu kistlerin nükse meyilli olmasından dolayı WHO tarafından 2005-2017 yılları arasında ‘keratokistik odontojenik tümör’ olarak adlandırılmış ve neoplazm sınıfında değerlendirilmiş ancak günümüzde tekrar kist sınıflamasına dahil edilmiştir. Bu olgu sunumunda daha önce lokal anestezi altında opere edilmeye çalışılmış, kronik enfeksiyondan ve lezyonun sinirin yerini de değiştirmesinden dolayı lokal anestezi sağlanamamış anksiyetik hastanın anestezi yönetiminden bahsedilmiştir.

Anahtar Kelimeler

• Odontojenik keratokist
• anestezi
• sedasyon
• Gow-Gates
• biyopsi

Kaynakça

1. Referens1.Eyre J, Zakrzewska J. The conservative management of large odontogenic keratocysts. Br J Oral Maxillofac Surg. 1985; 23: 195-203.
2. Referens2.Lee CA, Damm DD, Neville BW et al.(2008),Oral and maxillofacial pathology. 3th ed. St. Louis: Saunders
3. Referens3. Cawson RA, Odell EW.(1998), Essentials of Oral Pathology and Oral Medicine. 6th ed. Churchill Livingstone:Edinburgh.
4. Referens4.White SC, Pharoah MC.(2013), Oral radiology: principles and interpretation. 6th ed. St. Louis: Mosby.
5. Referens5.Morgan GE, Mikhail MS, Murray MJ. et al.(2015), Clinical Anesthesiology. 5th ed. New York: Mc Graw Hill.
6. Referens6.Das S, Ghosh S. Monitored anesthesia care: an overview. J Anaesthesiol Clin Pharmacol. 2015; 31: 27–9.
7. Referens7. Craig DC. Conscious sedation for dentistry: An update. Br Dent J. 2007;203:629–631.
8. Referens8 .Galeotti A, Garret Bernardin A, D’Antò V, et al. Inhalation conscious sedation with nitrous oxide and oxygen as alternative to general anesthesia in precooperative, fearful, and disabled pediatric dental patients: a large survey on 688 working sessions. Biomed Res Int 2016;72: 89-93.

9. Referens9. Benzoni T, Cascella M. Procedural sedation. Treasure Island: Stat Pearls. 2019.
10. Referens10. Tobias JD, Leder M. Procedural sedation: A review of sedative agents, monitoring, and management of complications. Saudi J Anaesth. 2011;5: 395-410.