Nasolabial cyst

Dr T Balasubramanian

Synonyms

Klestad't cyst

Non odontogenic cyst

Epithelial inclusion cyst

Fissural cyst

Characteristics

Common in females

Always extraosseous in its occurrence

Constantly located under ala nasi

Asymptomatic

No dental displacement

History

1882 Zukerland first described this entity. He coined the term nasolabial cyst

1913 Klestadt first proposed the inclusion theory as the cause for nasolabial cyst

1982 Brown Kelly described histological features of nasolabial cyst

Clinical features

Swelling over face in the nasolabial region

Same swelling over floor of the nose

Asymptomatic

Unilateral nasal block

Rarely pain (infection)

Histology

Nasolabial cyst is a soft tissue mass with epithelial lining filled with fluid

It originates from non odontogenic epithelium

Lining epithelium can be pseudostratified columnar, cuboidal epithelium or stratified squamous epithelium

Theories of nasolabial cyst

Theory I :This theory supposes that nasolabial cyst arises from entrapped nasolacrimal tissue

Klestadt theory: This theory proposes that these cysts arise form entrapped tissue within naso labial fissures. Hence he coined the term fissural cyst

Imaging

Coronal CT nose and pns showing nasolabial cyst

Anterior cut reveals the cyst

Note the non displacement of upper dentition

Surgery

Nasolabial cysts are ideally treated by surgery

Sublabial approach

Surgical steps

Infiltration

Incision

Sublabial incision

Care should be taken not to rupture the cyst

Use of 15 blade is ideal

Cyst exposure

Cyst could rupture like this

Cyst excision

Post excision cavity

Wound closure with catgut

Thank you

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