NON-SURGICAL TREATMENT WITH TYING OF MUCOCELE

봉합사를 이용한 점액종의 비외과적 처치

Mucocele is a mucous retention phenomenon which is caused by a laceration to the duct of minor salivary glands causing extravasation of mucin into the connective tissue forming a cyst-like space. Sialolithiasis of minor salivary glands and chronic obstruction of salivary glands may also cause such a phenomenon. Mucocele is a smooth, rounded sessile mass with diameters varying from 1 to 15mm of sudden appearance. Mucocele tying directly beneath the mucosa may rupture spontaneously and decrease in size, but frequently recurs. Lower lip is most frequently affected, and the mouth floor and buccal vestibule may also be affected. Enucleation of the cyst is needed and removal of minor salivary glands, marsupialization and cryotherapy may also be done. The mucocele frequently recurs after its removal. A 1-year-old female patient visited the hospital with a complaint of a swelling on the lower lip since 4 months before. She had no pain history but 4 months ago, fell and such symptom appeared since then. On her first visit, a bullous solid, opaque lesion of 5mm in diameter was noted. Treatment choice of surgical approach and nonsurgical approach were explained to the guardian. Considering the patient's age, the guardian agreed to a nonsurgical procedure. Treatment was carried out by tieing 3-0 silk to the base of the lesion. One week later, the tie loosened and was re-tied. A week later, the mucocele disappeared. Mucocele on the lower lip may be usually be treated by surgical removal, but this may traumatize the surrounding minor salivary gland causing it to recur. Also, surgicial removal may induce an ischemic change causing sialometaplasia. In case of young patients or children with management problems, non-surgical methods such as this tie method may be used. This tie method does not need any local anesthesia and has no pain, no secondary infection, and low bleeding tendency.

점액종은 외상으로 인해 구강에서 발생하는 흔한 낭성 병변이다. 하순에 흔히 발생하며 구강저와 순측 점막에도 자주 형성된다. 상순이나 경구개, 후구치대에는 거의 발생하지 않으며 발생빈도에 있어 성차는 없다. 점액종의 일반적인 치료는 낭종을 외과적으로 제거하고 이와 관련된 소타액선을 제거하거나 개창술을 시행하지만 재발할 수 있다. 본 증례는 하순의 물집을 주소로 본 치과 병원에 내원한 환아를 봉합사를 이용한 비외과적 술식으로 치료 후 6개월 동안 재발하지 않은 경우로 환아의 나이가 어리고 행동조절에 문제가 있는 경우 점액종을 비외과적인 방법으로 제거하여 양호한 결과를 얻었기에 보고하는 바이다.