Marsupialization

Marsupialization is a surgical technique used to convert a closed cyst or cavity into a permanently open drainage pathway. The procedure involves creating a window in the cyst wall and suturing the edges of the cyst lining to the adjacent mucosa, forming a continuous pouch that opens to the exterior or oral/vaginal surface. This drainage decompresses the lesion, reduces internal pressure, and often allows the surrounding bone and tissues to heal gradually.

Applications and indications

In dentistry, marsupialization is commonly used for large odontogenic cysts (for example, dentigerous cysts) to shrink the lesion and preserve adjacent teeth and bone, sometimes as a prelude to definitive enucleation. In gynecology, it is used for Bartholin gland cysts or abscesses to create a permanent drainage tract and reduce recurrence. The general rationale is to decompress a large or strategically located cyst where complete removal would be risky or causes substantial morbidity.

Technique and variations

The exact steps vary by site, but the core concept remains: create a cyst wall opening and secure its edges to the surrounding mucosa to maintain patency. The procedure may involve placement of a catheter or stent to keep the opening patent during healing. After marsupialization, the cyst often decreases in size over weeks to months, and additional treatment (such as enucleation or gland excision) may be planned once stabilization occurs.

Outcomes and risks

Marsupialization can reduce cyst size, preserve vital structures, and lower complication risk compared with immediate complete removal. Potential complications include infection, fistula formation, fistula healing issues, and recurrence of the cyst. Overall results depend on the cyst’s location, size, and underlying pathology, as well as adherence to postoperative care.