下颌骨大型牙源性角化囊性瘤口内摘除开放愈合的临床观察

发布时间：2018-04-09 07:11

本文选题：下颌骨　切入点：牙源性角化囊性瘤　出处：《华西口腔医学杂志》2014年06期

【摘要】：目的观察下颌骨大型牙源性角化囊性瘤(KCOT)摘除术后开放愈合的长期预后。方法于2003年9月—2011年4月通过手术治疗41例下颌骨大型KCOT(瘤腔最大径大于5 cm),采用口内切口摘除肿瘤,碘仿纱条填塞骨腔开放愈合,定期换药(每月2~3次)的治疗方式,观察术后并发症及骨再生修复情况,同时定期复查,观察肿瘤治疗远期预后。结果所有病例术中均发现下牙槽神经暴露于囊腔,部分与肿瘤囊壁粘连较紧密。摘除肿瘤术后开放愈合时间平均为8.9个月(3~15个月),无术后出血、感染、永久性下颌神经损伤等并发症,病变骨腔逐渐缩小消失,骨再生良好;病变累及区域牙齿的牙髓可保持活性,牙齿也逐渐稳固;患者面型及咬合功能恢复满意。平均随访时间为81.5个月(36~127个月),术后复发2例,复发率4.9%(2/41)。结论口内摘除肿瘤开放愈合的治疗方法显示出较为可靠的近远期治疗效果,可以为临床医师选择KCOT治疗方案提供参考。
[Abstract]:Objective to observe the long-term prognosis of open healing after resection of large odontogenic keratocyst tumor of mandible.Methods from September 2003 to April 2011, 41 patients with large mandibular KCOT (the maximum diameter of tumor cavity greater than 5 cm) were treated by surgery. The tumor was removed by intraoral incision, the osseous cavity was healed with iodoform gauze, and the medicine was changed regularly (2 times per month).The postoperative complications and bone regeneration were observed. At the same time, the long-term prognosis of tumor treatment was observed.Results in all cases, the inferior alveolar nerve was exposed to the cyst cavity, and some of them adhered closely to the tumor wall.The average open healing time after tumor removal was 8.9 months to 15 months. There were no complications such as postoperative bleeding, infection, permanent mandibular nerve injury, and the lesion bone cavity gradually decreased and disappeared, and bone regeneration was good.The pulp of the affected area could remain active and the teeth were gradually stable, and the patient's facial shape and occlusal function were satisfactory.The average follow-up time was 36-127 months (81.5 months), and the recurrence rate was 4.9% (2 / 41).Conclusion the treatment of open healing of intraoral extirpation of tumor shows a reliable short-term and long-term therapeutic effect, which can provide a reference for clinicians to choose KCOT treatment regimen.
【作者单位】：第四军医大学口腔医院口腔外科军事口腔医学国家重点实验室;
【基金】：国家自然科学基金面上项目资助项目(81371119)
【分类号】：R739.8

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