Nakamura N, Higuchi Y, Tashiro H, Ohishi M
First Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Kyushu University, Fukuoka, Japan.
J Oral Maxillofac Surg. 1995 Jul;53(7):748-54; discussion 755-6. doi: 10.1016/0278-2391(95)90323-2.
This study evaluated the effectiveness of marsupialization for the treatment of cystic ameloblastoma.
Clinical and histologic examination of 24 cystic ameloblastomas were performed before and after marsupialization.
Clinically and radiographically, the effect of marsupialization was evaluated as extremely effective (five cases), effective (11 cases), and noneffective (eight cases). Marsupialization was most effective in teenaged patients. In three cases, the tumor disappeared macroscopically, and further surgery was not done. Histologically, the growth characteristics of the tumor were classified into expansive and invasive types. Cytologic pattern was classified into three types according to the outer cell layer of the tumor parenchyme: cuboidal cell, columnar cell, and basal cell. Premarsupialization, the expansive pattern with the cuboidal cell type was dominant, whereas for postmarsupialization many cases that had been expansive changed to an invasive type showing columnar or basal cell types.
Marsupialization was found to be useful as a preliminary treatment of the cystic ameloblastoma. However, it must be borne in mind that following marsupialization the tumor still has a potential to infiltrate into the surrounding tissues.
本研究评估袋形术治疗囊性成釉细胞瘤的有效性。
对24例囊性成釉细胞瘤在袋形术前和术后进行临床及组织学检查。
临床及影像学评估显示,袋形术的效果为极其有效(5例)、有效(11例)和无效(8例)。袋形术在青少年患者中效果最佳。3例患者肿瘤在宏观上消失,未进行进一步手术。组织学上,肿瘤的生长特征分为膨胀型和浸润型。根据肿瘤实质的外层细胞层,细胞模式分为三种类型:立方体细胞、柱状细胞和基底细胞。袋形术前,以立方体细胞型的膨胀模式为主,而袋形术后,许多原本膨胀型的病例转变为浸润型,表现为柱状或基底细胞型。
发现袋形术作为囊性成釉细胞瘤的初步治疗方法是有用的。然而,必须牢记,袋形术后肿瘤仍有浸润周围组织的可能性。