What is the treatment for a cyst on the inner lower lip?

Treatment for a Cyst on the Inner Lower Lip

Surgical excision is the definitive treatment for a cyst on the inner lower lip, with an intraoral approach being preferred to avoid visible scarring.

Types of Cysts on the Inner Lower Lip

Several types of cysts can occur on the inner lower lip:

1. Mucous extravasation cyst (mucocele) - Most common type, resulting from trauma to minor salivary glands
2. Epidermoid implantation cyst - Often related to previous trauma
3. Sebaceous cyst - Less common on the inner lip

Diagnostic Approach

Before treatment, proper diagnosis is essential:

• Visual examination of the cyst characteristics (size, color, consistency)
• Palpation to determine if the cyst is fixed or mobile
• Assessment of any symptoms (pain, discomfort during eating/speaking)
• History of trauma or previous lesions in the area

Treatment Algorithm

1. Small, Asymptomatic Cysts (<3 cm)

• Option A: Observation

  • Appropriate for small, non-interfering cysts
  • Monitor for changes in size or symptoms
  • If stable, continue routine follow-up

• Option B: Surgical excision

  • Recommended for definitive treatment
  • Intraoral approach to avoid visible scarring 1
  • Complete removal of the cyst wall to prevent recurrence

2. Symptomatic or Larger Cysts (>3 cm)

• Surgical excision is strongly recommended
  • Intraoral approach through the buccinator muscle or orbicularis oris muscle 1
  • Complete removal of the cyst with its wall is essential

3. Recurrent or Complex Cysts

• Complete surgical excision with histopathological examination
  • Ensures proper diagnosis and rules out rare malignant transformation
  • May require more extensive dissection

Surgical Technique

The preferred surgical approach involves:

1. Local anesthesia administration
2. Intraoral incision (avoiding external scarring)
3. Blunt dissection through the oral mucosa and muscle layer
4. Complete excision of the cyst with its wall
5. Irrigation of the surgical site
6. Closure with absorbable sutures

This technique has shown excellent outcomes with complete recovery and no recurrence in patients with lip cysts 1.

Post-Surgical Management

• Soft diet for 24-48 hours
• Oral rinses with chlorhexidine or saline solution
• Pain management with over-the-counter analgesics if needed
• Follow-up examination after 7 days to assess healing
• Monitoring for potential recurrence

Important Considerations

• Complete excision is crucial - Partial removal increases risk of recurrence
• Histopathological examination - Always recommended to confirm diagnosis 2, 3
• Minimally invasive approach - Intraoral technique avoids visible scarring while allowing complete removal 1

Pitfalls to Avoid

• Incomplete excision of the cyst wall (leads to recurrence)
• External incisions that cause visible scarring
• Failure to obtain histopathological confirmation
• Aggressive manipulation that may damage surrounding structures

While other treatment options like marsupialization or decompression exist for certain oral cysts, complete surgical excision remains the gold standard for lip cysts to ensure definitive treatment and prevent recurrence 2.