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一项关于将卡诺氏液用作囊性病变辅助治疗剂导致下牙槽神经损伤的临床研究。

A clinical study of inferior alveolar nerve damage caused by Carnoy's solution used as a complementary therapeutic agent in a cystic lesion.

作者信息

Jo Hyun-Jun, Kim Hee-Youl, Kang Dong-Cheol, Leem Dae-Ho, Baek Jin-A, Ko Seung-O

机构信息

Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonbuk National University Dental Hospital, 20, Geonji-ro, Deokjin-gu, Jeonju-si, Jeollabuk-do Republic of Korea.

出版信息

Maxillofac Plast Reconstr Surg. 2020 May 25;42(1):16. doi: 10.1186/s40902-020-00257-4. eCollection 2020 Dec.

Abstract

BACKGROUND

Cyst enucleation, which extracts only the tumor with the application of Carnoy's solution (CS), has been suggested as a conservative treatment with a low recurrence rate and morbidity. However, there has been a concern that CS's contact with inferior alveolar nerve (IAN) can cause neurons to degenerate and cause sensory dysfunction. The purpose of this retrospective cohort study aimed to investigate the neurosensory function after surgical treatment with or without the application of CS.

METHODS

While controlling the effects of sex, age, follow-up period, and invasion size of the tumor, we performed the binary logistic regression analysis to examine whether or not the sensory function of the patients who were treated with CS ( = 19) for the cyst enucleation procedure was significantly different from those who were not treated with CS ( = 58) at the end of the follow-up period.

RESULTS

The logistic regression result showed that the use of CS was not significantly related to the normalness of sensory function at the end of the follow-up period. Rather, the invasion size of the cyst was significantly associated with sensory dysfunction.

CONCLUSIONS

CS may be used for patients who are diagnosed with OKC and UAM without much fear of its impact on sensory dysfunction. However, a small number of patients who were treated with CS experienced severe sensory damage and did not recover at the end of the follow-up period, suggesting the need for further analysis of these patients.

摘要

背景

囊肿摘除术仅切除肿瘤并应用卡诺氏液(CS),已被认为是一种复发率和发病率较低的保守治疗方法。然而,人们担心CS与下牙槽神经(IAN)接触会导致神经元退化并引起感觉功能障碍。这项回顾性队列研究的目的是调查在手术治疗中应用或不应用CS后的神经感觉功能。

方法

在控制性别、年龄、随访期和肿瘤侵犯大小的影响的同时,我们进行二元逻辑回归分析,以检查在囊肿摘除术中接受CS治疗(n = 19)的患者与未接受CS治疗(n = 58)的患者在随访期结束时的感觉功能是否存在显著差异。

结果

逻辑回归结果显示,在随访期结束时,CS的使用与感觉功能正常与否没有显著关系。相反,囊肿的侵犯大小与感觉功能障碍显著相关。

结论

对于被诊断为牙源性角化囊肿(OKC)和单囊型成釉细胞瘤(UAM)的患者,可以使用CS,而不必过于担心其对感觉功能障碍的影响。然而一小部分接受CS治疗的患者在随访期结束时出现了严重的感觉损伤且未恢复,这表明需要对这些患者进行进一步分析。

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本文引用的文献

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J Craniomaxillofac Surg. 2017 Feb;45(2):244-251. doi: 10.1016/j.jcms.2016.11.010. Epub 2016 Nov 19.
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Is there a role for enucleation in the management of ameloblastoma?眼球摘除术在成釉细胞瘤的治疗中是否有作用?
Int J Oral Maxillofac Surg. 2009 Aug;38(8):807-12. doi: 10.1016/j.ijom.2009.02.018. Epub 2009 Mar 17.
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Unicystic ameloblastoma of the maxilla: a case report.上颌骨单囊性成釉细胞瘤:一例报告
J Indian Soc Pedod Prev Dent. 2007 Apr-Jun;25(2):106-10. doi: 10.4103/0970-4388.33459.
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A review of odontogenic keratocysts and the behavior of recurrences.牙源性角化囊肿及其复发行为的综述。
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Jan;101(1):5-9; discussion 10. doi: 10.1016/j.tripleo.2005.03.023.

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