单囊型成釉细胞瘤行开窗减压术联合刮治术的临床研究

目的:探讨开窗减压术联合刮治术治疗单囊型成釉细胞瘤的治疗效果和预后。方法:20例单囊型成釉细胞瘤行开窗减压术,术后佩戴超软热凝树脂塞治器,Ⅱ期行刮治术,术后严密随访,观察瘤腔变化。结果:锥形束CT显示病变范围明显缩小,病变区解剖结构接近正常。开窗术后3个月瘤腔平均缩小28.66%,术后6个月平均缩小58.51%,术后12个月平均缩小为79.33%,瘤腔面积与术前比较明显缩小(P<0.05)。术后6个月瘤腔骨密度冠状位、矢状位及水平位分别为371.32、361.74、384.71 Hu,术后12个月分别为517.64、523.22、521.05 Hu,与术前相比有明显差异(P<0.05)。术后12~24个月行二期刮治,随访3~5年无复发。结论:单囊型成釉细胞瘤行开窗减压术,术后佩戴超软热凝树脂塞治器能维持开窗口通畅,在瘤腔变化不明显时进行二期刮治术,是治疗单囊型成釉细胞瘤的一种有效方法。

Clinical Study of Decompression Combined with Curettage for Unicystic Ameloblastoma

Objective:To investigate the efficacy and prognosis of decompression combined with curettage for unicystic ameloblastoma.Methods:20 cases of unicystic ameloblastoma were treated with decompression.The cyst plug with soft liner thermosetting resin was used to keep the wound open and a second stage curettage was performed.The changes of tumor cavity were observed after the operation.Results:Patient imaging showed that the lesion range was significantly reduced,and the anatomy of the lesion area was close to normal.The tumor cavity decreased by 28.66%on average 3 months after operation,and decreased by 58.51%on average 6 months,decreased by 79.33%on average 12 months.After the surgery,the sizes of the tumor cavity shrank,all these had statistical significance(P<0.05).Then 6 months later,the bone mineral densities at coronal and sagittal and horizontal respectively were 371.32 Hu,361.74 Hu,and 384.71 Hu.Followed-up 12 months,the bone mineral densities increased to 517.64 Hu,523.22 Hu,and 521.05 Hu(P<0.05).The second stage curettage was performed 12 to 24 months after operation.No recurrence of tumor was observed in the 3 to 5 years of follow up.Conclusion:It is an effective method for the treatment of unicystic ameloblastoma by decompression combined with curettage.And the cyst plug with soft liner thermosetting resin was used to keep the wound open.Second stage curettage was performed when the changes of tumor cavity were not obvious.