Prajapati V K, Shahi Ajoy Kumar, Prakash Om
Department of Oral and Maxillofacial Surgery, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, 834009 India.
Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):2350-2355. doi: 10.1007/s12070-020-02172-6. Epub 2020 Sep 29.
Large benign odontogenic neoplasms of mandible are not rare in developing countries such as India. Treatment of choice depends not only on extent and size of the lesion but also the socio-economic status, resources and available armamentarium. Whenever resection of segment mandible is planned for these patients, goal of the treatment should not be to restore function of the mandible alone but also to give esthetic visual appearance of the face. The present study was performed to determine postoperative functional and esthetic outcome in such patients. A total of 18 patients (20-35 years) with benign odontogenic neoplasm of mandible were enrolled for the study. After surgical intervention i.e., resection and reconstruction of mandible with mandibular reconstruction plate, all the patients were evaluated post-operatively for functional and esthetic outcome at the end of 1st and 4th week. Functional outcome were assessed based on Quality of life questionnaire and esthetic outcome based on vancouver scar assessment scale, clinical and radiological assessment. The mean scores of all the functional outcomes was improved significantly like pain, drooling of saliva, eating solid and liquid and speech except deglutition. The mean score of scar was recorded as 4.67. Occlusion was achieved in 100% and lips competency in 89% of patients. It is advised to immediately reconstruct the mandible after segmental mandibulectomy which eventually helps to improve the quality of life post-operatively of patients being treated for benign odontogenic neoplasm of mandible.
在印度等发展中国家,下颌骨大型良性牙源性肿瘤并不罕见。治疗方法的选择不仅取决于病变的范围和大小,还取决于社会经济地位、资源和可用的医疗设备。每当为这些患者计划切除下颌骨节段时,治疗目标不应仅仅是恢复下颌骨的功能,还应使面部具有美观的视觉外观。本研究旨在确定此类患者术后的功能和美学效果。共有18名(20 - 35岁)下颌骨良性牙源性肿瘤患者纳入本研究。在进行手术干预,即使用下颌骨重建钢板进行下颌骨切除和重建后,所有患者在术后第1周和第4周结束时接受功能和美学效果评估。功能效果根据生活质量问卷进行评估,美学效果根据温哥华瘢痕评估量表、临床和影像学评估进行评估。除吞咽外,所有功能结果的平均得分如疼痛、流口水、进食固体和液体以及言语等均有显著改善。瘢痕平均得分为4.67。100%的患者实现了咬合,89%的患者唇部功能正常。建议在节段性下颌骨切除术后立即重建下颌骨,这最终有助于改善接受下颌骨良性牙源性肿瘤治疗患者的术后生活质量。