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不同治疗方法后牙源性黏液瘤的复发率:一项系统评价

Recurrence rate of odontogenic myxoma after different treatments: a systematic review.

作者信息

Saalim M, Sansare K, Karjodkar F R, Farman A G, Goyal S N, Sharma S R

机构信息

Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, India.

University of Louisville, Independent Consultant in Maxillofacial Imaging Science based in Chicago.

出版信息

Br J Oral Maxillofac Surg. 2019 Dec;57(10):985-991. doi: 10.1016/j.bjoms.2019.09.005. Epub 2019 Sep 21.

Abstract

Our aim was to establish the recurrence rate of odontogenic myxoma after different treatments. Our search covered papers from 1972-2017 from different sources. The papers were evaluated and critically appraised by two independent investigators. The recurrence rate and 95% CI were calculated in relation to each specific treatment, and the chi squared test was calculated to find out if there was any significant difference in the recurrence rate between conservative treatment and resection. The overall recurrence rate was 5 of 39 patients (13%) during a mean follow up period of 10 years. With conservative treatment the recurrence rate was 4/22 (19%) (mean follow up 11 years) and after resection it was 1/17 (6%) (mean follow up nine years). Maxillary lesions were more likely to recur than mandibular ones. Quality of life variables such as disfigurement and neural deficit were more common after resection than with conservative treatment. The frequency of recurrence was relatively low over 10 years' follow up, irrespective of whether resection or a more conservative approach was used, despite being slightly lower (as might be expected) after resection. Conservative treatment should be considered first to avoid resection-associated morbidity and the effect on the quality of life. Maxillary lesions have more room to spread before they are clinically evident, making them difficult to treat optimally and contributing to the recurrence rate.

摘要

我们的目的是确定不同治疗方法后牙源性黏液瘤的复发率。我们检索了1972年至2017年来自不同来源的论文。这些论文由两名独立的研究人员进行评估和严格评价。计算每种特定治疗方法的复发率和95%置信区间,并进行卡方检验以确定保守治疗和切除术后复发率是否存在显著差异。在平均10年的随访期内,39例患者中有5例(13%)出现总体复发。保守治疗的复发率为4/22(19%)(平均随访11年),切除术后为1/17(6%)(平均随访9年)。上颌病变比下颌病变更容易复发。与保守治疗相比,切除术后诸如毁容和神经功能缺损等生活质量变量更为常见。无论采用切除术还是更保守的方法,在10年的随访中复发频率相对较低,尽管切除术后复发率略低(正如预期的那样)。应首先考虑保守治疗,以避免与切除相关的发病率及其对生活质量的影响。上颌病变在临床上明显之前有更多的扩散空间,这使得它们难以得到最佳治疗并导致复发率升高。

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