PMC3304184_01
Soft, tender, pulsatile swelling in left mandibular region
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F1
On detailed examination after 12 hours, a soft, pulsatile, tender swelling with audible bruit was noted in left submental region [Figure 1].
Preoperative OPG showing moth eaten irregular radiolucency in left mandibular parasymphysis body region with enlarged and torturous mandibular canal; adjacent teeth are displaced
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F2
The ill-defined moth eaten type radiolucency involved left mandibular parasymphysial body region; also inferior alveolar canal was dilated and tortourous with enlarged mental foramen [Figure 2].
Axial CT and Coronal CT section demonstrating widespread destruction and thinning of cortical plates.
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F3
Axial, coronal sections of computed tomography (CT) scan revealed multiseptae central bony destructive lesion with expansion of bicortical plates without perforation [Figures 3a, b].
Resected mandibular segment containing focal lesion
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F4
Using extracorporeal technique, teeth were extracted in the involved segment, followed by curettage and hollowing of mandible with curretes, rotating handpiece and bur [Figures 4 and 5].
Extracorporeal technique of extraoral removal of teeth and curettage of lesion
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F5
Using extracorporeal technique, teeth were extracted in the involved segment, followed by curettage and hollowing of mandible with curretes, rotating handpiece and bur [Figures 4 and 5].
Reimplantation of mandibular segment and stabilization with miniplates
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F6
Stabilization of reimplanted mandibular piece was done with three 2.5 mm miniplates [Figure 6].
Postoperative OPG showing good alignment of mandibular lower border and fixation with plates at symphysis and angle
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F7
During follow up of 2 years, ultrasound revealed no new vascular lesion in the region while excellent facial form and function was maintained [Figures 7 and 8].
Postoperative radiograph showing maintenance of normal anatomical contour
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F8
During follow up of 2 years, ultrasound revealed no new vascular lesion in the region while excellent facial form and function was maintained [Figures 7 and 8].