Tabrizi Reza, Özkan Birkan Taha, Dehgani Ali, Langner Nicole Janine
Department of Oral and Maxillofacial Surgery, Craniomaxillofacial Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
J Craniofac Surg. 2012 Sep;23(5):e459-61. doi: 10.1097/SCS.0b013e31825b3308.
The odontogenic keratocyst (OKC) is an unusual cyst with a high recurrence rate. The most common site for OKCs is by far the mandible. The best treatment of OKC remains controversial. Recurrence rates ranging anywhere from less than 10% to more than 60% have been reported. The aim of our study was to evaluate marsupialization as a treatment option for OKC.
We managed 13 patients (8 male, 5 female) between the ages of 16 and 31 years (mean, 22.4 y) with biopsy-proven OKC. Radiographically, the patients' cyst sizes were between 25 and 90 mm. Treatment consisted of marsupialization. We followed up with patients for a total duration of at least 60 months, and posttreatment visits were carried out at 6-month intervals.
We documented cured or reduced cyst size with radiography. The odontogenic keratocyst resolved completely in 10 patients, and the cyst walls shrank in 3 patients. The latter patients required a second operation to remove the associated impacted teeth. A histologic evaluation of 3 lesions showed metaplasia. Any case of recurring cysts was not seen during the entire follow-up period.
Marsupialization is an effective and conservative treatment option for OKC. Nevertheless, future studies should conduct even longer follow-up periods to evaluate any recurrence of lesions.
牙源性角化囊肿（OKC）是一种具有高复发率的特殊囊肿。迄今为止，OKC最常见的部位是下颌骨。OKC的最佳治疗方法仍存在争议。据报道，复发率在不到10%至超过60%之间。我们研究的目的是评估袋形术作为OKC的一种治疗选择。
我们治疗了13例年龄在16至31岁（平均22.4岁）之间经活检证实为OKC的患者（8例男性，5例女性）。影像学检查显示，患者囊肿大小在25至90毫米之间。治疗方法为袋形术。我们对患者进行了至少60个月的随访，治疗后每6个月进行一次复诊。
通过影像学检查记录到囊肿治愈或缩小。10例患者的牙源性角化囊肿完全消退，3例患者的囊肿壁缩小。后3例患者需要二次手术拔除相关的阻生牙。对3个病变进行组织学评估显示有化生现象。在整个随访期间未发现囊肿复发的病例。
袋形术是治疗OKC的一种有效且保守的治疗选择。然而，未来的研究应进行更长时间的随访以评估病变是否复发。
