Li J T W, Wan C C J, Yeung A W K, Leung Y Y, Su Y-X
Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong.
Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong.
Int J Oral Maxillofac Surg. 2025 Jun 18. doi: 10.1016/j.ijom.2025.06.009.
One of the frequent manifestations of Gorlin-Goltz syndrome (GGS), a rare autosomal dominant disorder, is the development of odontogenic keratocysts (OKCs). The aim of this study was to evaluate the efficacy and safety of treatment modalities for OKCs in GGS patients, and their corresponding recurrence/new lesion rates and complications. Twelve GGS patients (eight male, four female) with 36 OKCs were included. Common clinical features of GGS were calcification of the falx cerebri (eight patients, 66.7%), macrocephaly (seven patients, 58.3%), and frontal bossing (six patients, 50%). Enucleation with Carnoy's solution was the primary treatment for 10 patients, while two underwent marsupialization. The mean follow-up was 13.3 years. Nine (75%) of the patients did not experience any early complications (up to 1 month postoperative). The OKC recurrence/new lesion rate was 83.3% after surgical treatment (enucleation or marsupialization), with five patients (41.7%) experiencing two occurrences of OKCs during follow-up (range 2.7-29.9 years). Enucleation of OKCs with Carnoy's solution is a safe and effective approach in GGS patients. However, the high recurrence/new lesion rate underscores the need for close long-term monitoring for at least 7 years and consideration of more aggressive surgical methods in these patients.
戈林-戈尔茨综合征(GGS)是一种罕见的常染色体显性疾病,牙源性角化囊肿(OKC)的发生是其常见表现之一。本研究的目的是评估GGS患者中OKC治疗方式的疗效和安全性,以及相应的复发/新病变率和并发症。纳入了12例患有36个OKC的GGS患者(8例男性,4例女性)。GGS的常见临床特征为大脑镰钙化(8例患者,66.7%)、巨头症(7例患者,58.3%)和额部隆突(6例患者,50%)。10例患者的主要治疗方法是用卡诺氏液摘除囊肿,另外2例患者接受了袋形缝合术。平均随访时间为13.3年。9例(75%)患者未出现任何早期并发症(术后1个月内)。手术治疗(摘除或袋形缝合术)后OKC的复发/新病变率为83.3%,5例患者(41.7%)在随访期间(2.7 - 29.9年)出现两次OKC。用卡诺氏液摘除GGS患者的OKC是一种安全有效的方法。然而,高复发/新病变率凸显了对这些患者进行至少7年密切长期监测的必要性,并考虑采用更积极的手术方法。