Resnick Cory M, Dentino Kelley M, Garza Ricardo, Padwa Bonnie L
Instructor, Harvard School of Dental Medicine, Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA.
Clinical Research Fellow, Department of Plastic and Oral Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA.
J Oral Maxillofac Surg. 2016 Jun;74(6):1153-8. doi: 10.1016/j.joms.2015.12.014. Epub 2016 Jan 7.
Idiopathic bone cavities (IBCs) are benign osseous pseudocysts of unclear etiology. Their clinical course and response to treatment are poorly understood. The purpose of this study was to present a case series of patients with IBC with long-term follow-up.
A retrospective case series of patients with IBC of the jaw was implemented. Medical records were reviewed for data on presentation and imaging. All patients underwent surgical exploration to confirm the diagnosis. Follow-up radiographs were evaluated for resolution or persistence after the procedure. Descriptive data were summarized.
The sample included 45 patients (60% girls) with 47 IBCs who presented at a mean age of 13.5 ± 0.35 years (range, 9 to 17 yr). All lesions were asymptomatic and discovered as incidental findings; the average size was 2.0 cm (range, 0.8 to 7 cm). Most (n = 44) were solitary lesions of the mandible presenting within the body (n = 27), symphysis (n = 15), or ramus (n = 2). One patient had synchronous bilateral mandibular and maxillary IBCs. Common radiographic features included scalloping without root resorption or displacement and cortical thinning without expansion or perforation. Intraoperative findings showed an empty bone cavity often filled with blood-tinged serous fluid or blood. The histopathology of scrapings from the bony wall showed benign mixed fibrous tissue and no epithelial lining. Average radiographic follow-up was 32.7 ± 6.7 months (range, 0 to 9 yr). After exploration and curettage, 43% of patients had complete bone fill within 2 to 5 years. The other 57% had no change in lesion size at an average of 2.25 years (range, 2 to 9 yr). No patients developed symptoms, had enlargement of the lesion, or had pathologic fracture.
Many IBCs persist for years despite exploration and curettage. Nonetheless, unresolved lesions did not enlarge or cause harm. A single procedure to confirm the diagnosis is sufficient for management.
特发性骨腔（IBCs）是病因不明的良性骨假性囊肿。对其临床病程及治疗反应了解甚少。本研究的目的是呈现一组接受长期随访的IBC患者病例系列。
实施了一项关于颌骨IBC患者的回顾性病例系列研究。查阅病历以获取临床表现及影像学数据。所有患者均接受手术探查以确诊。术后评估随访X线片，观察病变消退或持续情况。总结描述性数据。
样本包括45例患者（60%为女孩），共47个IBC，平均发病年龄为13.5±0.35岁（范围9至17岁）。所有病变均无症状，为偶然发现；平均大小为2.0 cm（范围0.8至7 cm）。多数（n = 44）为下颌骨的孤立性病变，位于体部（n = 27）、联合部（n = 15）或升支（n = 2）。1例患者同时出现双侧下颌骨和上颌骨IBC。常见的影像学特征包括呈扇贝样改变但无牙根吸收或移位，皮质变薄但无膨胀或穿孔。术中所见显示为一个空的骨腔，常充满血性浆液或血液。骨壁刮除物的组织病理学检查显示为良性混合纤维组织，无上皮衬里。平均影像学随访时间为32.7±6.7个月（范围0至9年）。经探查和刮除术后，43%的患者在2至5年内骨腔完全填充。另外57%的患者病变大小无变化，平均时间为2.25年（范围2至9年）。无患者出现症状、病变增大或病理性骨折。
尽管进行了探查和刮除，许多IBC仍持续数年。尽管如此，未消退的病变并未增大或造成损害。单次确诊手术足以进行治疗管理。
