Briki Sondes, Elleuch Wael, Karray Fathi, Abdelmoula Mohamed, Tanoubi Issam
MD. Maxillofacial Surgery Department, Faculty of medicine of Sfax, Tunisia.
MD, MA. (ed). Centre d'Apprentissage des Attitudes et Habiletés Cliniques (CAAHC), Simulation center of the Université De Montréal.
J Clin Exp Dent. 2019 Jun 1;11(6):e565-e569. doi: 10.4317/jced.55563. eCollection 2019 Jun.
Since the 4th edition of the World Health Organization's Classification of Head and Neck Tumours was published in January of 2017, the keratocystic odontogenic tumor is back into the cyst category as odontogenic keratocyst (OKC). Depending on the size of the cyst, its location and the patients' age, several treatment options are available: curettage, enucleation, radical treatment and marsupialization. The marsupialization is a conservative technique used in early tumor stages, as curative treatment for the odontogenic cyst. Despite its disadvantages and controversies, the marsupialization remains an interesting therapeutic choice in the case of large cysts, or in very young or old patients. We describe, in this article, four clinical cases of odontogenic cysts. We report the surgical management and the subsequent evolution of the patients. The discussion focuses on the indications, advantages and limitations of the odontogenic cyst's marsupialization. We review the specific conditions of the odontogenic cysts that could make the marsupialization the optimal therapeutic option. In our cases, the marsupialization proved to be a conservative technique which allowed the respect of neighboring anatomical structures, particularly in the case of large cysts, but requires prolonged clinical and radiological monitoring. Pathological entity for our cases was different. Thus, the treatment outcome may be different too. This series is very small and the reader should be cautious about drawing broad conclusions regarding the optimal therapeutic choice. Marsupialization, odontogenic cyst.
自2017年1月世界卫生组织《头颈部肿瘤分类》第4版出版以来,角化囊性牙源性肿瘤又重新归为囊肿类别,称为牙源性角化囊肿(OKC)。根据囊肿大小、位置及患者年龄,有多种治疗选择:刮除术、摘除术、根治性治疗和袋形缝合术。袋形缝合术是用于肿瘤早期阶段的一种保守技术,作为牙源性囊肿的根治性治疗方法。尽管存在缺点和争议,但对于大型囊肿或非常年轻或年老的患者,袋形缝合术仍是一种值得考虑的治疗选择。在本文中,我们描述了4例牙源性囊肿的临床病例。我们报告了患者的手术治疗及后续病情发展。讨论集中在牙源性囊肿袋形缝合术的适应证、优点和局限性。我们回顾了可能使袋形缝合术成为最佳治疗选择的牙源性囊肿的具体情况。在我们的病例中,袋形缝合术被证明是一种保守技术,能够保护邻近解剖结构,特别是对于大型囊肿的情况,但需要长期的临床和影像学监测。我们病例的病理实体不同。因此,治疗结果也可能不同。本系列病例数量非常少,读者在就最佳治疗选择得出广泛结论时应谨慎。袋形缝合术,牙源性囊肿。