What is the Difference Between Enucleation and Marsupialization?

Enucleation and marsupialization are two different surgical techniques used to treat cysts, particularly in the dental context. The main differences between these two procedures are:

1. Removal of the cystic lining: Enucleation involves the complete removal of the cystic lining with healing by primary intention, while marsupialization leaves the cystic lining in place and instead converts the cyst into a pouch by suturing the cyst lining to the oral mucosa.
2. Purpose: Enucleation is generally used to treat small cysts, ensuring a complete removal of the cystic capsule. Marsupialization, on the other hand, is preferred for large cysts, especially those adjacent to vital structures such as the maxillary sinus and inferior alveolar nerve. Marsupialization is also used when preservation of the displaced teeth is desirable, as it facilitates cyst-associated tooth eruption and avoids tooth extraction.
3. Postoperative care: Enucleation usually requires less aftercare compared to marsupialization, which necessitates proper wound care and regular check-ups to ensure the cavity stays clean and resolves over time.
4. Degree of invasion: Enucleation is considered a more radical method, as it involves the complete removal of the cystic lining, while marsupialization is a more conservative approach that leaves the pathologic tissue in situ.

In some cases, enucleation may be performed after marsupialization, as the latter can be used as a preliminary step to reduce the size of the cyst before enucleation.

Comparative Table: Enucleation vs Marsupialization

Here is a table comparing the differences between enucleation and marsupialization:

Please note that the recurrence rates mentioned above are specific to the treatment of keratocystic odontogenic tumors (KOTs) and may not apply to other conditions.