Shi Sailang, Liu Yanming, Shan Yidan, Fu Tao, Zhao Shifang
Dental Clinic, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, PR China; Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, PR China.
Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, PR China.
J Craniomaxillofac Surg. 2014 Dec;42(8):1659-63. doi: 10.1016/j.jcms.2014.05.009. Epub 2014 May 22.
Aggressive resection of a large mandibular cystic ameloblastoma may cause severe deformity and dysfunction, while simple enucleation may carry a high risk of recurrence. The purpose of this study was to evaluate, in terms of both recurrence and the preservation of contour and function, the effectiveness of enucleation combined with peripheral ostectomy (Enu/PO) in managing large mandibular cystic ameloblastomas.
Fourteen patients who had large mandibular cystic ameloblastoma (11 unicystic, 3 multicystic) and had been treated with the Enu/PO were reviewed.
The follow-up period was 19-117 months. Using Enu/PO, mandibular continuity was preserved in all patients, and only one patient complained of permanent lip numbness. With bone regeneration, the thinned bone plate significantly thickened and the residual cavity shrank. No pathological fracture occurred. There was recurrence in 3 patients. Two recurrences were treated with radical surgery, and the other with Enu/PO. No new recurrence was found thereafter. All patients were satisfied with their facial appearance.
The Enu/PO technique is excellent in preserving appearance and functions and with a low risk of recurrence, is a reliable option for the management of large mandibular cystic ameloblastomas.
积极切除大型下颌骨囊性成釉细胞瘤可能会导致严重的畸形和功能障碍，而单纯摘除术则可能具有较高的复发风险。本研究的目的是从复发以及外形和功能保留方面评估摘除术联合周边骨切除术（Enu/PO）治疗大型下颌骨囊性成釉细胞瘤的有效性。
回顾性分析14例接受Enu/PO治疗的大型下颌骨囊性成釉细胞瘤患者（单囊性11例，多囊性3例）。
随访时间为19至117个月。采用Enu/PO，所有患者的下颌骨连续性得以保留，仅有1例患者主诉永久性唇部麻木。随着骨再生，变薄的骨板明显增厚，残余腔隙缩小。未发生病理性骨折。3例患者复发。2例复发患者接受了根治性手术，另1例接受了Enu/PO治疗。此后未发现新的复发情况。所有患者对其面部外观均满意。
Enu/PO技术在保留外形和功能方面效果良好，复发风险低，是治疗大型下颌骨囊性成釉细胞瘤的可靠选择。
