Song I S, Park H S, Seo B M, Lee J H, Kim M J
Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, Seoul, Republic of Korea.
Department of Oral and Maxillofacial Surgery, Dental Research Institute, Seoul National University Dental Hospital, Seoul, Republic of Korea.
Br J Oral Maxillofac Surg. 2015 Nov;53(9):841-8. doi: 10.1016/j.bjoms.2015.06.024. Epub 2015 Jul 26.
Decompression is effective in reducing both the size of cystic lesions on jaws and the associated morbidity of resection. However, quantitative measurement of reduced volume after decompression among different cystic diseases has not been fully investigated. We have retrospectively investigated the difference in reduction in volume among keratocystic odontogenic tumours (n=17), unicystic ameloblastomas (n=10), and dentigerous cysts (n=10) of the posterior mandible using 3-dimensional computed tomography (CT). Various other influential factors such as age, sex, the presence of impacted teeth, and the number of drains were also recorded. There was no significant difference in the speed of shrinkage among the 3 groups, but there was a significant correlation (p<0.01) between the initial detected volume of the lesion and the absolute speed of shrinkage in each type of cyst. Initial volume was also significantly associated (p<0.01) with reduction of total volume in each type of cyst. Age may correlate negatively with the rate of reduction in dentigerous cysts, which means that the older the patient is, the less the reduction. Treatment seemed to last longer as the speed of shrinkage lessened in the keratocystic tumours and dentigerous cysts (p<0.05) as multiple regression has shown. The relative speed of shrinkage of unicystic ameloblastomas seemed to be slower when an impacted tooth was involved in the lesion (p=0.019). However, the sample size was too small to make any definite statistical statement. These results suggest that the rate of reduction of volume was related to the original size of the lesion. Despite the need for a second operation and longer duration of treatment compared with excision alone, decompression is a valuable way of reducing the size of large cystic lesions, with low morbidity and recurrence rate. There was no difference in the rate of reduction according to the underlying histopathological picture.
减压术对于减小颌骨囊性病变的大小以及降低相关切除手术的发病率是有效的。然而，不同囊性疾病减压术后体积减小的定量测量尚未得到充分研究。我们使用三维计算机断层扫描（CT）对下颌骨后部的牙源性角化囊性瘤（n = 17）、单囊性成釉细胞瘤（n = 10）和含牙囊肿（n = 10）体积减小的差异进行了回顾性研究。还记录了其他各种影响因素，如年龄、性别、阻生牙的存在情况以及引流管数量。三组之间的缩小速度没有显著差异，但每种类型囊肿的初始检测体积与绝对缩小速度之间存在显著相关性（p<0.01）。初始体积与每种类型囊肿的总体积减小也显著相关（p<0.01）。年龄可能与含牙囊肿的缩小率呈负相关，这意味着患者年龄越大，缩小程度越小。如多元回归所示，随着牙源性角化囊性瘤和含牙囊肿缩小速度的降低，治疗时间似乎更长（p<0.05）。当病变累及阻生牙时，单囊性成釉细胞瘤的相对缩小速度似乎较慢（p = 0.019）。然而，样本量太小，无法做出任何明确的统计学陈述。这些结果表明，体积减小率与病变的原始大小有关。尽管与单纯切除相比，减压术需要二次手术且治疗时间更长，但它是减小大型囊性病变大小的一种有价值的方法，发病率和复发率较低。根据潜在的组织病理学表现，缩小率没有差异。
