Background: The intraoral approach for surgical enucleation may be used for small cysts with a diameter of 6 cm and less,
however larger lesions i.e. more than 6 cm in diameter which are extending below the mylohyoid muscle and involving the
submental and submandibular spaces require an extra oral incision.
Aim of the study: To evaluate the validity of the intraoral surgical approach for enucleation of large plunging sublingual
dermoid cysts which extended below the mylohyoid muscles.
Patients and methods: 7 patients (15 to 33 years old) had been suffered from sublingual dermoid cysts. They were presented
with complaints of slowly growing painless mass in the floor of the mouth, difficulties in chewing and swallowing solid foods.
All selected cases included cysts diameters ≥ 6 cm. All cases were operated under general anesthesia and subjected to complete
enucleation through the intraoral approach. Pain, swelling, trismus, salivary flow and lingual nerve injuries were evaluated
immediately, 7 days and 30 days after surgery.
Results: a significant reduction of pain after 30 days p < 0.05 and no statistically significant changes between immediate and
after 30 days according to trismus assessment. A statistically significant reduction in swelling between immediate and after 30
days. No change in Salivary flow or affection and nerve injuries were reported through the follow up period. no recurrences of
all cystic lesions were detected 1 year postoperative follow-up.
Conclusion: The intraoral sublingual approach could be used safely to access and excise large plunging sublingual dermoid
cysts regarding clinical outcomes.