Transnasal endoscopic marsupialization of nasopalatine duct cysts: A novel ‘Mickey Mouse’ sign and a septum-sparing surgical technique to reduce paresthesia risk

Abstract

A nasopalatine duct cyst (NPDC) is the most common type of non-odontogenic cyst in the maxillary region and oral cavity. Recently, a novel transnasal endoscopic approach has been described to allow marsupialization of NPDCs, with good outcomes. However, one common complication appears to be paresthesia of the palate around the upper incisors, which is thought to occur due to damage to the nasopalatine nerve following the septal incision. In this case report, we introduce a variant of this endoscopic technique that attempts to minimize damage to this nerve by adopting a septum-sparing flap. We report no complications, including no paresthesia, at the 3-month follow-up. We also report a novel ‘Mickey Mouse’ sign on MRI imaging associated with this NPDC.

Keywords:

• Nasopalatine duct cyst
• transnasal
• endoscopic
• marsupialization
• complications

Disclosure statement

No potential conflict of interest was reported by the author(s).