Studart Soares Eduardo Costa, de Medeiros José Rômulo, Bezerra Tácio Pinheiro, Nogueira Carlos Bruno Pinheiro, Costa Fábio Wildson Gurgel, Nogueira Alexandre Simões
Oral and Maxillofacial Surgery Service, Walter Cantídio University Hospital, Federal University of Ceará, Fortaleza, Brazil.
Oral Maxillofac Surg. 2013 Sep;17(3):209-12. doi: 10.1007/s10006-012-0358-1. Epub 2012 Aug 30.
Ossifying fibroma (OF) is a well-defined benign neoplasm characterized by slow growth and predilection for the posterior mandible site, usually treated by conservative surgical approaches. In this context, Le Fort I Approach (LFIA) has been increasingly used providing good visualization and an easy access to the lesion. It also allows removal of the lesion quickly. Although there are case reports using LFIA for the management of benign neoplasms, odontogenic cysts and tumors of the middle third of face, to our knowledge, only one article describes the use of surgical LFIA for OF of the maxilla. Thus, the objective of this study was to report the second paper on the use of horizontal osteotomy of the maxilla in the resection of an extensive OF and conduct a brief literature review on this surgical approach.
The following case report describes a 33-year-old man who was diagnosed with OF. Oral examination showed a painless swelling of hard consistency, covered by normal mucosa in edentulous alveolar ridge of the maxillary posterior region of the right side. Tomographic slices revealed that the image with mixed density had a centrifugal growth, with expansion of the buccal and lingual cortical with an upper displacement of the maxillary sinus. The patient was admitted to the hospital for surgical resection of the lesion via LFIA. Satisfactory functional results were obtained after 18-month follow-up period. In addition, no recurrence or clinical complaints were noted.
LFIA shall be considered as a feasible option when planning surgery for removal of extensive benign lesions located in midfacial region because it is a predictable technique and routinely performed by the oral and maxillo-facial surgeons.
骨化性纤维瘤(OF)是一种边界清晰的良性肿瘤,其特点是生长缓慢,好发于下颌骨后部,通常采用保守手术方法治疗。在这种情况下,勒福Ⅰ型截骨术(LFIA)越来越多地被使用,它能提供良好的视野,便于接近病变部位,还能快速切除病变。虽然有病例报告使用LFIA治疗良性肿瘤、牙源性囊肿和面部中1/3的肿瘤,但据我们所知,只有一篇文章描述了使用外科LFIA治疗上颌骨的OF。因此,本研究的目的是报告第二篇关于使用上颌骨水平截骨术切除广泛OF的文章,并对这种手术方法进行简要的文献综述。
以下病例报告描述了一名33岁被诊断为OF的男性。口腔检查显示右侧上颌后部无牙牙槽嵴处有一个质地硬、无痛的肿胀,表面覆盖正常黏膜。断层扫描显示混合密度图像呈离心性生长,颊侧和舌侧皮质膨胀,上颌窦向上移位。患者入院通过LFIA进行病变的手术切除。随访18个月后获得了满意的功能结果。此外,未发现复发或临床不适。
在计划手术切除位于面中部的广泛良性病变时,LFIA应被视为一种可行的选择,因为它是一种可预测的技术,并且口腔颌面外科医生经常进行。