Ⅰ期开窗减压、Ⅱ期刮治术在下颌骨大型囊肿治疗中的应用

目的 探讨采用Ⅰ期开窗减压与Ⅱ期囊肿刮治联合术式治疗下颌骨大型囊肿并保持下颌骨完整性的临床疗效。方法 回顾性分析2011年6月—2013年6月年蚌埠医学院第一附属医院口腔科手术治疗的28例下颌骨大型囊肿患者的临床资料。其中男18例、女10例,年龄9～84岁;囊肿长轴4.5~14.3 cm;牙源性角化囊肿12例,含牙囊肿16例。均采用Ⅰ期开窗减压、Ⅱ期刮治术治疗,术后定期随访,根据临床表现及X线检查评估囊肿缩小的程度。结果 所有患者在Ⅰ期开窗减压术后囊腔均有明显缩小,囊腔内成骨明显。Ⅰ期手术后12～22个月,囊腔变化趋于稳定时行Ⅱ期刮治术。Ⅱ期手术前,口腔曲面体层X线片示:囊腔长轴平均缩小76%。Ⅱ期刮治术后患者下颌骨及牙齿得以保留。28例患者均随访1～3年,平均14个月,随访期间均未见囊肿复发。结论 联合应用Ⅰ期开窗减压、Ⅱ期刮治术治疗下颌骨大型囊肿,既能保存颌骨,又能缩短单独开窗减压术的治疗时间,是下颌骨大型囊肿的优选治疗方法。

The application of fenestration decompression and curettage techniques for treatment of large mandibular cyst

Objective To evaluate the effect of fenestration decompression on Ⅰ stage and curettage technique on Ⅱ stage treated large mandibular cyst.Methods Twenty-eight patients with large mandibular cyst treated in the First Affiliated Hospital of Bengbu Medical College from June 2011 to June 2013, of which 18 males and 10 females, aged from 9 to 84 years old, including 12 patients for keratinous cyst and 16 patients for dentigerous cyst. To observe the changes of cystic cavity and evaluate the clinical curative effect dependent on the radiographic postoperative imaging.Results After fenestration decompression, cystic space reduction was noticed in all cases. And it was clear that there was bone-formation in cysts cavity. After 12 to 22 months of Ⅰstage operation, the change of cystic space was stable. Then these cases were treated by curettage technique on Ⅱstage. BeforeⅡ stage resection, it was displayed in orthopantomography that the long axis of cystic space reduced as much as 76% on average. Jaw and teeth could be retained. Twenty-eight patients were followed up for 1-3 years(averaged 14 months),during which no recurrence was noted.Conclusions Using fenestration decompressing and curettage to treat large mandibular cyst can shorten the treatment time and retain jaw, which is an optimizing therapy.