Maxfacts

Cyst

For the most part cysts of the skin and cysts of the jaws are treated in a similar fashion and heal along very similar timelines. There are a couple of exceptions which are made clear below. We’ve structured this in what could seem a repetitive fashion to help you find the healing process most suitable to your cyst and its treatment.

Radicular cyst

Time-lines short term: this cyst is enucleated (scooped out) leaving a hole in the bone. This is sore for about 1-2 weeks. The stitches often feel tight until they dissolve (very few are removed nowadays). Unless the wound becomes infected the discomfort gradually eases.

Time-lines medium term: the area of surgery may be tender but not painful for a couple of months. If a tooth has been root treated or apicected (root resected), biting on it or chewing may be uncomfortable until new bone forms.

Time-lines long term: after 6 months new bone should have filled in the hole in the bone and both clinically and by X-ray things should be completely back to normal. Continuing pain or discharge usually mean a failure of root treatment or apicectomy.

Residual cyst

Time-lines short term: essentially as above although no tooth involved.

Time-lines medium term: as above but healing is more rapid and the bone defect rarely gets infected as there is no source of irritation or infection.

Time-lines long term: usually completely healed by 3 – 6 months.

Dentigerous cyst

Time-lines short term: the removal of the cyst is usually part of tooth (for example a wisdom tooth) removal. The symptoms are usually related to the tooth removal.

Time-lines medium term: unless the cyst has been marsupialised, this is the same as for removal of the relevant tooth.

Time-lines long term: as above.

Eruption cyst

Time-lines short term: minor discomfort for a few days after de-roofing of the mucosa overlying the relevant tooth.

Time-lines medium term: providing the tooth below erupts, essentially no medium term issues.

Time-lines long term: see medium term.

Nasopalatine cyst

Time-lines short term: pain and discomfort for around 10 days.

Time-lines medium term: at 3 - 4 weeks an area of numbness behind the front teeth.

Time-lines long term: the numbness usually resolves long term.

Nasolabial cyst

Time-lines short term: discomfort; the exact post-operative sequalae depend on the approach used.

Time-lines medium term: small scar if an external approach is used.

Time-lines long term: as above.

Keratocyst

Time-lines short term: similar to any large cyst; pain, discomfort and swelling. If certain additional treatments are used (such as cryotherapy or Carnoy solution) the discomfort may last longer. Possibility of numbness of the lower lip if a bottom jaw operation. Possibility of nose bleeds if the upper jaw.

Time-lines medium term: after 4 – 6 weeks all swelling should have settled down. These operations are often more extensive than for other cysts. Numbness if present will persist.

Time-lines long term: these cysts do recur so expect to be followed up by regular (annual) X-ray, although this does not need to be at a hospital. If numbness was present it will settle after 18 months if it is going to.

Aneurysmal bone cyst

Time-lines short term: bruising and swelling can be extensive as these are very vascular lesions.

Time-lines medium term: there may be tenderness and bruising up to 6 – 8 weeks after surgery depending on how extensive it was.

Time-lines long term: low chance of recurrence if removed entirely but these are rare lesions and rules are not hard and fast.

Solitary bone cyst

Time-lines short term: quick to heal as long as incision line does not break down.

Time-lines medium term: very quickly heals as the surgery was essentially just to let the bone cavity fill with blood that turns into bone.

Time-lines long term: usually no problems after a few months.

Oral dermoid cyst

Time-lines short term: extensive swelling especially under the tongue, so extra attention to normal swallowing is important. Wounds can breakdown so need to be kept very clean.

Time-lines medium term: within a month things are essentially back to normal.

Time-lines long term: unless this was a very large dermoid approached from the neck, there will be no issues. If approached from the neck, a horizontal neck scar will be present and take 12 – 18 months to get to its best state in terms of appearance.

Angular dermoid cyst

Time-lines short term: approached via skin (whether neck or corner of the eye), so tender wound, stitches removed at 6 – 7 days and standard wound care.

Time-lines medium term: unless the dermoid crossed the skull (as is the case of some at the corner of the eye) usually no issues at 1 month.

Time-lines long term: as with all external scars 12 – 18 months for full wound healing.

Mucocele

Time-lines short term: swelling for 10 -14 days. Stitches may be removed or left to dissolve.

Time-lines medium term:  rarely some loss of sensation in the operated area.

Time-lines long term: biggest problem is recurrence as these are caused by damaged minor salivary glands and the surgery itself may have damaged some of them.

Ranula

Time-lines short term: swelling in the floor of the mouth. This can be extensive – see oral dermoid (above). The sublingual gland should be removed for most of these which can cause swelling and numbness. New techniques to avoid this show promise but also fail.

Time-lines medium term: can recur and sometimes does so early. Numbness of the floor of mouth and side of tongue is possible as is obstruction of the submandibular duct which can lead to blockage of the submandibular gland.

Time-lines long term: recurrence and long term numbness are possible but unusual. Removal of the submandibular gland is sometimes needed.

Branchial cyst

Time-lines short term: neck scar and stitches. Drain overnight. Stitches out in 6-10 days (surgeons vary a lot on this). Possible numbness of ear. Swelling, mild discomfort.

Time-lines medium term: scar, numbness of ear.

Time-lines long term: the scar reaches its best appearance at 12 -18 months although very few people really notice it after a month or so. The numbness usually improves with time.

Cystic hygroma / lymphangioma

Time-lines short term: macrocystic lymphangiomata are similar to branchial cyst (see above).

Time-lines medium term: see branchial cyst.

Time-lines long term: see branchial cyst.

Thyroglossal duct cyst

Time-lines short term: stitches and drain immediately after surgery. Stitches out at 6 – 10 days.

Time-lines medium term: swallowing can be uncomfortable for a few weeks but usually resolved by second month. This is due to the necessary removal of the middle portion of the hyoid bone. Scar settles well and quickly.

Time-lines long term: scar settles well. Recurrence a problem if the section of hyoid bone is not removed so be aware of that, otherwise full recovery anticipated by 6 months.