Chen Lei, Zhang Xu-Hui, Zhou Ping, Zhao Yi-Fang, Hu Yan-Ping, Jia Jun, Yu Zi-Li
State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 430079, Wuhan, PR China.
Department of Oral Surgery, Stomatological Hospital of Xiamen Medical College, 361000, Xiamen, PR China.
J Stomatol Oral Maxillofac Surg. 2025 Jun;126(3S):102190. doi: 10.1016/j.jormas.2024.102190. Epub 2024 Dec 5.
To analyze causes of recurrence following radical mandibular resection of ameloblastoma, and to propose surgical variation.
We conducted a retrospective analysis of patients treated for ameloblastoma from 2012 to 2024, specifically those who underwent radical mandibular resection followed by reconstruction with autologous bone flaps, focusing on cases of recurrence.
Six patients were included in the study, all with primary tumors located in the mandible. Recurrence occurred 5 to 23 years post-surgery. Two patients had recurrence within the residual mandible due to insufficient margins, necessitating further resection and reconstructed with bone flaps Three patients had recurrences associated with residual tumor cells in the soft tissue, which affected the grafted bone: two required extensive resection and additional bone flap reconstruction, while one had a limited recurrence that was managed by soft tissue excision. Additionally, one patient had an isolated soft tissue recurrence that was addressed through resection.
Adequate resection margins are vital to minimizing recurrence risk. Invasive procedures should be avoided to prevent tumor spread, and thorough excision of affected areas during surgery is essential.
分析成釉细胞瘤下颌骨根治性切除术后复发的原因，并提出手术改进方法。
我们对2012年至2024年接受成釉细胞瘤治疗的患者进行了回顾性分析，特别关注那些接受下颌骨根治性切除并随后用自体骨瓣重建的患者的复发情况。
该研究纳入了6名患者，所有患者的原发肿瘤均位于下颌骨。复发发生在术后5至23年。2名患者因切缘不足在残余下颌骨内复发，需要进一步切除并使用骨瓣重建；3名患者的复发与软组织中的残余肿瘤细胞有关，这影响了移植骨：2名患者需要广泛切除并额外进行骨瓣重建，而1名患者复发范围有限，通过软组织切除进行处理。此外，1名患者出现孤立的软组织复发，通过切除进行治疗。
足够的切除切缘对于将复发风险降至最低至关重要。应避免侵入性操作以防止肿瘤扩散，手术期间彻底切除受影响区域至关重要。
