What Is a Nasolabial Cyst?
Nasolabial cysts, also known as nasoalveolar cysts or Klestadt's cysts, are soft-tissue enlargements that develop between the top lip and nose. Although it genuinely starts in the uterus during fetal development, the issue typically does not show symptoms until maturity.
This cyst is not odontogenic, meaning that the cells that make it are not the same cells that form teeth. From the outside, it appears to be a swelling beneath the skin, but when viewed from inside the mouth, it is more visible under the top lip.
How Common Is Nasolabial Cyst?
Nasolabial cysts, an uncommon entity in jaw cysts, represent only around 1 percent of cases within this category and approximately 2.5 percent of non-odontogenic. Adults are the primary victims, and the fourth and fifth decades of life are when it is most common. In addition, it demonstrates a gender bias, favoring women by a ratio of about 3:1. Although rare, nasolabial cysts provide clinical issues since they can cause discomfort and aesthetic concerns in those who are affected. Accurate diagnosis and treatment of this illness depend critically on understanding these demographic nuances.
Where Does the Nasolabial Cyst Develop?
Nasolabial cysts develop on the soft tissues of the face, particularly in the region where the nose and upper lip meet. Unlike several other cysts in the jaw region, it does not damage the bone beneath. Therefore, referring to it as a nasoalveolar cyst would be deceptive, implying that it affects both the nose (nasal) and the bone where the teeth are located (alveolar). Since it mainly affects the soft tissues in that area, it would be more accurate to refer to it as a nasolabial cyst.
How Does the Nasolabial Cyst Develop?
Two main theories attempt to explain the origin of nasolabial cysts, although there are still many unknowns. According to the first notion, they could form from tissue remnants during womb development, specifically from areas connected to the tear ducts. Examining the proteins in the cysts, which resemble those in healthy tear ducts, lends some credence to this theory. The second explanation, less common today, contends that the cysts may develop due to tiny tissue fragments becoming lodged where the faces converge during development. These theories aid in understanding the potential origins of these cysts, but further research is required to be specific.
What do Nasolabial Cysts Look Like?
Nasolabial cysts usually do not cause harm and develop slowly, measuring at least 3 centimeters. A non-tender, variable, movable swelling is palpable in the alar area. The soft-tissue swelling can fill in the labial vestibule intraorally, with or without nasal obstruction, raise the ala or the floor of the nose (or both), and completely obliterate the nasolabial fold. The lesion may burst on its own and drain through the nose, mouth, or, rarely, a cutaneous fistula (connection between two organs).
Although they rarely cause issues or are even invisible, they can occasionally make it difficult to breathe through the nose or hurt if they become infected. For those who have these cysts, swelling is the most typical concern. This swelling may push up the nostril from the outside and give the side of the nose a puffy appearance. Sometimes, because of their location, there may appear to be a dental issue. They can dissolve the fold that separates the lips and cheeks inside the mouth. Approximately 10 percent of these cysts show up on both cheeks.
What Are the Symptoms of Nasolabial Cyst?
The symptoms of the Nasolabial cyst are:
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There is an appearance of a slightly swollen area beneath the facial skin. The skin fold that runs from the nose to the angle of the mouth is called the nasolabial fold, and the swelling is located in this area. Consequently, the edema is nearer the nose than the lip. The swelling may cause the lip and nasal ala to press outward, deforming the face.
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Though it occasionally appears on both sides, the cyst often only affects one.
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Painless, the swelling ranges from mild to firm. It can get bigger over time.
How to Diagnose Nasolabial Cyst?
It is important to distinguish nasolabial cysts from other cysts in the facial region. There are various more cysts than these.
A diagnosis is determined by:
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The patient's medical history.
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A physical examination of the oral cavity may detect the existence of a pink or blue-colored cyst.
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Radiographic analysis is used to distinguish nasolabial cysts from other localized enlargements. However, nasolabial cysts are not readily seen on X-rays. If the underlying bone is eroded, changes can be observed. Other frequently utilized radiological examinations include magnetic resonance imaging (MRI) and Computed Tomography (CT) scans.
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After the cyst is surgically removed, a biopsy can be carried out to confirm the diagnosis.
What Is the Treatment of Nasolabial Cyst?
The primary treatment for nasolabial cysts is surgical excision, which attempts to remove the cyst entirely while reducing the chance of recurrence. Various surgical techniques are available, each with advantages and things to consider.
1. Excision of the Entire Cyst: In this method, the entire cyst and any potentially impacted surrounding tissue are surgically removed. Depending on the size and location of the cyst, the surgeon may make an incision intraorally or externally along the nasolabial fold. Ensuring total removal while protecting neighboring structures requires careful dissection.
2. Sclerosing Substance Injection: Sclerosing compounds can sometimes be injected into a cyst to harden it and facilitate surgical removal. This method guarantees total elimination of the cyst contents and is frequently used as an adjuvant to surgical excision to lower the chance of recurrence.
3. Using a Nasal Endoscope, Perform Marsupialization: This procedure involves opening the cyst and leaving it open so it can freely empty into the nasal cavity. A nasal endoscope (an instrument used to look inside a body cavity or organ) is used for this treatment, allowing for precise vision and manipulation of the cyst. For significant or recurring cysts, marsupialization can be very helpful, as it aids in decompressing the cyst and accelerating healing.
Conclusion
Nasolabial cysts are rare lesions that can be difficult to diagnose and treat. Early detection and adequate treatment are essential to avoid problems and restore patients' comfort and appearance. More research is required to fully comprehend the genesis of this syndrome and the best management practices.
