PMC3385503_01
Preoperative photograph shows swelling on the leftside of the face.
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F1
An 18-year-old female presented with a painful slowly expanding swelling of left maxilla that had started approximately 3 months earlier [Figure 1].
(a) Coronal CT scan section shows the lesion completely obliterating the maxillary sinus, extending in to the nasal cavity and floor of the orbit. (b) Sagittal CT scan section shows the extension of the lesion toward the posterior surface of maxilla and pterygoid plates.
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F2
Root resorption of teeth 25, 26, and 27 was evident indicating the aggressiveness of the lesion [Figures 2a and 2b].
Histopathological examination using hematoxylin and eosin stain at 10X magnification shows diffused distribution of giant cells.
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F3
The histopathplogical examination showed diffused distribution of giant cells and confirmed an aggressive GCG [Figure 3].
Unilateral Le fort I osteotomy with midpalatal split to access the lesion.
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F4
The underlying bone was exposed and Le Fort I cuts were performed, followed by mid-palatine split and down fracture of the left side maxilla [Figure 4].
Curettage and complete removal of the lesion.
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F5
This provided excellent visibility and access to the entire lesion.The lesion was excised with the help of surgical curettes and the entire bony margins were visualized for any remnants [Figure 5].
Stabilization of the Le Fort I segment with L-shaped miniplate and screws.
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F6
Hemostasis was achieved and then the ostetomised maxilla was reduced and fixed with the help of a 4-hole 'L' plate and screws made of Titanium [Figure 6].
Postoperative orthopantomograph after 1 year.
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F7
Patient was checked at regular intervals with radiographs [Figure 7] and CT scans [Figure 8].
Two-year postoperative follow-up CT scan.
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F8
Patient was checked at regular intervals with radiographs [Figure 7] and CT scans [Figure 8].