单囊性成釉细胞瘤开窗减压术的疗效观察

Application of marsupialization in the treatment of unicystic ameloblastoma

关键词:  单囊性成釉细胞瘤  开窗减压术  囊腔缩小

Key words:  unicystic ameloblastoma  marsupialization  cyst reduction

摘要:

目的 分析开窗减压术后单囊性成釉细胞瘤的囊腔缩小情况。方法 收集大连市口腔医院收治的单囊性成釉细胞瘤实施开窗减压术36例患者的临床资料，拍摄术前及术后复查的全景曲面断层片，测量囊腔最大径，计算囊腔大小，比较囊腔缩小情况。结果 36例实施开窗减压术的患者中，囊腔增大4例，实施Ⅱ期手术3例。总有效率为88.9%。术后观察期可见新生的骨小梁结构，骨密度增厚，术后3个月、6个月、12个月的囊腔缩小率依次为（17.3±14.8）%、（36.7±25.4）%、（58.7±26.5）%。术后12个月显著有效占25.0%。囊腔缩小有效者占36.1%，囊腔缩小率在性别、年龄、囊腔大小方面差异无统计学意义。结论 开窗减压术能有效缩小单囊性成釉细胞瘤的病变范围，最大限度地保持上颌骨及下颌骨的形态和功能，使患者的生存质量得以提高。

Abstract:

Objective To analyze the volume reduction of unicystic ameloblastoma after marsupialization. Methods A total of 36 patients from Dalian Stomatological Hospital with unicystic ameloblastoma were treated with marsupialization. Pre- and post-operative panoramic films were taken before and after the procedure. The maximum diameter of the cystic lesion was measured and the volume was calculated. Reduction rate of the cystic lesion was evaluated. Results Among 36 patients, 3 patients required further treatment via enucleation or curettage, and 4 patients had an increase in cystic lesion volume 12 months after marsupialization. The total effective rate was 88.9%. During post-operative observation period, new trabecular bone structure was seen and bone mineral density increased. Cystic lesions had shrunk by an average of (17.3±14.8)% at 3 months, (36.7±25.4)% at 6 months, and (58.7±26.5)% at 12 months. The outcome was significantly effective in 25.0% and moderate in 36.1% of the cysts. The reduction rate and size of cystic lesions was significantly different after marsupialization. There was no significant difference in the cyst reduction rate in terms of gender, age, and cyst size. Conclusions Marsupialization, as a treatment for unicystic ameloblastoma, is effective in reducing cystic lesion size and maintain the function and shape of maxilla and mandible to the maximum extent, so that the quality of life of patients can be improved.