|Year : 2006 | Volume
| Issue : 5 | Page : 31-32
Nasopalatine duct cyst
Rahul J Hegde1, R Shetty2
1 Department of Pediatric and Preventive Dentistry, Y. M. T. Dental College and Hospital, Kharghar, Navi Mumbai - 410 210, India
2 Former Post graduate student, P. M. N. M. Dental College and Hospital, Bagalkot, Karnataka, India
Rahul J Hegde
Department of Pediatric and preventive Dentistry, Y. M. T. Dental College and Hospital, Kharghar, Navi Mumbai - 410 210
Nasopalatine duct cyst is an intraossseous developmental cyst of the midline of the anterior palate. Management of a case of nasopalatine duct cyst in a 10 yr old male child is reported.
Keywords: Incisive canal cyst, median alveolar cyst, median palatine cyst, palatine papilla cyst
|How to cite this article:|
Hegde RJ, Shetty R. Nasopalatine duct cyst. J Indian Soc Pedod Prev Dent 2006;24:31-2
| Introduction|| |
The Nasopalatine duct cyst (NPDC) was first described by Meyer in 1914., Nasopalatine duct cyst also termed as incisive canal cyst, arises from embryologic remnants of nasopalatine duct. Most of these cysts develop in the midline of anterior maxilla near the incisive foramen. It is one of the most common non odontogenic cysts of the oral cavity occurring in about 1% of the polulation. The majority of cases occur between 4th and 6th decades of life. Slightly more common in males than women, the ratio being 3:1.
Trauma or infection of the duct and mucous retention of adjacent minor salivary glands have been mentioned as possible etiologic factors, but the role of each has been questioned., Although pathogenesis of this lesion is still uncertain, the lesion most likely represents a spontaneous cystic degeneration of remnants of the nasopalatine duct.
| Case Report|| |
A 10 year old boy reported to Dept. of Pediatric Dentistry with the chief complaint of swelling in a anterior region of palate since 1 month. Careful history revealed that swelling began 1 month back and gradually attained present size. Patient did not have any pain but only complained of salty taste. Extraorally their was no abnormality and there was no lymphadenopathy detected.
Intraoral examination revealed a bluish discoloration in the incisive papilla region [Figure - 1]. Swelling was measuring 1.5 cm in the midline of hard palate and extended posteriorly upto mesial aspect of first permanent molar. Radiographic examination of occlusal view showed well circumscribed oval shaped radiolucency located in midline of the anterior maxilla between roots of central incisors [Figure - 2]. On the basis of clinical and radiographic evidence provisional diagnosis of Nasopalatine dust cyst was made. It was decided to enucleate the cyst-under general anaesthesia. Prior to surgery all preliminary investigations were done and results were within normal range. Palatal mucoperiosteal flap was raised to expose the cyst [Figure - 3]. A friable, haemmorhegic cyst lining was curetted and sent for histopathological examination [Figure - 4]. The flap was sutured back in its original position [Figure - 5]. Patient was called for suture removal one week postoperatively. Recall showed satisfactory healing.
Microscopic examination revealed fibrous wall lined by thin stratified squamous epithelium and partly by pseudo stratified columnar epithelium. A few nerve bundles and blood vessels were seen in cyst wall [Figure - 6]. These histological features, in conjunction with the site of lesion, suggested nasopalatine duct cyst.
| Discussion|| |
The Nasopalatine duct cyst is a developmental cyst derived from proliferation of embryonic epithelial remnants of the nasopalatine duct. It may occur at any age but most common seen in fourth to sixth decades of life. In the largest study of 334 Nasopalatine duct cysts, overall mean age was 42.5 years. This case is of particular clinical interest as it is rare for a Nasopalatine duct cysts to present in such a young patient and it is therefore important that clinician should be aware of the features of this cyst as nearly 40% of the cases are totally asymptomatic and found only during routine clinical examination. Due to extent of the lesion, surgical enucleation was the choice of treatment. Our case demonstrated typical clinical, radiographical and histopathological features of Nasopalatine duct cyst.
| References|| |
|1.||Meyer AW. A unique supernumerary Paranasal sinus directly above the superior incisors. J Anato My 1914;48:118-29. |
|2.||Ely N, Sheehy E, McDonald F. Nasopalatine duct cyst: A case report. Int J Ped Dent 2001;11:135-7. |
|3.||Sapp P, Lewis, Wysocki. Contemporary oral and maxiofacial pathology. 2nd ed. Mosby: p. 62-3. |
|4.||Brad Neville: Textbook of oral pathology In: Developmental defects of the oral and maxiofacial region 1st ed. Saunders: p. 25. |
|5.||Regezi, Sciubba, Jordan. Oral pathology clinical pathologic correlations. Saunders: p. 256-7. |
|6.||Shear M. Cyst of the oral regions. 3rd ed. Vargheese Publishing: p. 111-23. |
|7.||Staretz L, Brian B. Well defined radiolucent lesion in the maxillary anterior region. J Am Dent Assoc 1990;120:335-6. |
|8.||Swansonks, Kaugars GE. Nasopalatine Duct Cyst. An analysis of 334 cases. J Oral Maxiofacial Surg 1991;49:268-71. |
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[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4], [Figure - 5], [Figure - 6]
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