Custom 3D-printed decompression valve with protective cap for managing large mandibular lesion

Objectives: Decompression is a well-established technique for managing large cysts, aiming to reduce osmotic pressure and lesion size, thereby facilitating subsequent surgical intervention with reduced risk and avoiding extensive maxillofacial reconstructions. This technical note presents a custom-designed decompression valve with a protective cap to address common challenges in traditional decompression techniques. Technical note: A 24-year-old male presented with facial swelling, significant edema in the left mandibular region, and an osteolytic lesion identified via CT scan. The lesion was hypothesized to be an odontogenic cyst. A two-stage surgical approach was implemented. The first stage involved biopsy and placement of a custom-designed decompression valve. Using 3D Slicer® and Blender ® software, a patient-specific valve was fabricated with four suture holes for secure placement and a screwable protective cap to prevent foreign material ingress and facilitate irrigation. The valve was 3D-printed using Poly-Lactic-Acid (PLA). Post-procedure, the diagnosis was confirmed as an odontogenic keratocyst. The valve remains in place, awaiting sufficient lesion size reduction before proceeding with the second surgical stage. Conclusion: The described custom decompression valve represents an innovative, patient-centered approach that enhances traditional decompression techniques. Its accessibility, affordability, and effectiveness make it a valuable tool in managing large odontogenic cysts, especially in resource-constrained environments. Further studies may explore broader applications and long-term outcomes of this technology.