Odontogenic cystic lesions are among most common diseases affecting maxillofacial region. There are two main lines of treatment for odontogenic cysts, enculation and marsupilization or a combination of them. Marsupilization has the advantage of being simple procedure with minimal surgical trauma. However it has many disadvantages including limited accessibility for cyst de-roofing and frequent irrigation in certain areas such as mandibular ramus region. The commonest marsupialization techniques uses an acrylic bulb that prevent the marsupialized opening from closure, this technique is extremely difficult or even impossible to use in inaccessible areas, as the ascending ramus of the mandible.It is very difficult for children to maintain the a large marsupialized area cleaned. The present study presents our 3 years follow up of the use of our algorism in the management of odontogenic cystic lesions, with the use of the marsupilization decompression tube which facilitate flexible hygienic method of decompressing large in accessible odontogenic lesions in adults and children.