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单囊型成釉细胞瘤:临床-放射影像学与组织病理学相关性及其处理。

Unicystic ameloblastoma: Clinico-radiological and histopathological correlation with management.

机构信息

Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, Bahadur Shah Zafar Marg, New Delhi 110002, India.

Department of Oral and Maxillofacial Pathology, Maulana Azad Institute of Dental Sciences, Bahadur Shah Zafar Marg, New Delhi 110002, India.

出版信息

J Plast Reconstr Aesthet Surg. 2024 Oct;97:296-301. doi: 10.1016/j.bjps.2024.07.042. Epub 2024 Jul 26.

Abstract

Unicystic ameloblastoma is a distinct entity of ameloblastoma characterized by slow growth and locally aggressive behavior. This retrospective study aimed to assess the efficacy of different treatment modalities of unicystic ameloblastoma, focusing on clinico-radiological and histopathological features. Data from patients diagnosed with unicystic ameloblastoma were retrospectively analyzed. Patients were categorized into luminal and intraluminal (Group A) and mural (Group B) variants based on the Ackermann classification, which has a significant influence on their biological behavior, treatment approaches, and prognosis. Patients in Group A underwent enucleation with chemical cauterization, peripheral ostectomy, and iodoform packing, whereas those in Group B were treated with resection and reconstruction. Post-operatively, the patients were subjected to radiographic assessments via digital orthopantomogram at regular intervals. Because of the rarity of unicystic ameloblastoma, only 17 patients were included in the study (Group A: 9 patients; Group B: 8 patients), with a mean follow-up of 4.9 years (range: 1.4-11.8 years). The primary outcome measure was the absence of recurrence, which indicated treatment success. No patient in either group experienced recurrence within the follow-up period. This study provides evidence supporting the successful treatment of luminal and intraluminal variants of unicystic ameloblastoma in young individuals using a conservative approach. However, the more aggressive mural variant demonstrated favorable outcomes with radical treatment. These findings emphasize the importance of the Ackermann classification in guiding treatment decisions for unicystic ameloblastoma and contribute valuable insights into optimizing therapeutic strategies based on clinico-radiological and histopathological findings.

摘要

单囊型成釉细胞瘤是成釉细胞瘤的一种特殊类型,其特点为生长缓慢且局部侵袭性强。本回顾性研究旨在评估不同治疗方法治疗单囊型成釉细胞瘤的疗效,重点关注临床-影像学和组织病理学特征。

回顾性分析诊断为单囊型成釉细胞瘤的患者数据。根据 Ackermann 分类将患者分为囊内和囊内(A 组)和壁内(B 组)变体,这对其生物学行为、治疗方法和预后有重要影响。A 组患者行囊内切除术,辅以化学烧灼、骨切除术和碘仿填塞,B 组患者行切除术和重建术。术后定期通过数字化全景片进行影像学评估。

由于单囊型成釉细胞瘤罕见,本研究仅纳入 17 例患者(A 组:9 例;B 组:8 例),平均随访 4.9 年(范围:1.4-11.8 年)。主要结局指标为无复发,即治疗成功。两组均无患者在随访期间复发。

本研究为使用保守方法成功治疗年轻患者的囊内和囊内变体单囊型成釉细胞瘤提供了证据。然而,侵袭性更强的壁内变体采用根治性治疗后也取得了良好的效果。这些发现强调了 Ackermann 分类在指导单囊型成釉细胞瘤治疗决策中的重要性,并为基于临床-影像学和组织病理学发现优化治疗策略提供了有价值的见解。

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