下颌骨成釉细胞瘤治疗回顾性分析  

A clinical retrospective study of mandibar amelo-blastoma

作　　者：朱瑾[1] 韩德民[1] 孙远[2] 张从纪[2] 李慧贞[2] 周锦川[2] 

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,北京100730 [2]第三军医大学西南医院头颈口腔颌面外科,重庆400038

出　　处：《中国耳鼻咽喉头颈外科》2005年第9期545-547,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的分析下颌骨成釉细胞瘤手术效果,为选择合适的手术方式总结经验。方法对17例随访5年以上成釉细胞瘤患者的临床资料,包括肿瘤临床病理分型、手术方式和术后复发率进行了回顾性分析。结果17例中单囊型13例,实型或多房型4例。保守性手术7例,复发3例;根治性手术10例,其中2例采用血管化游离腓骨重建下颌骨,共复发1例。4例复发病例均为单囊型,其中3例采用保守性手术。结论彻底切除肿瘤是减少复发的关键,但根治性手术会增加下颌骨外形和功能重建的难度,选择手术方式时需权衡利弊,综合考虑患者需求和肿瘤的范围等因素。血管化游离腓骨是下颌骨重建的可选择方式。OBJECTIVE To summarize the clinical experience for the choice of proper operative approach and to analyze the factors related to the recurrence of mandibular ameloblastoma. METHODS The clinical data of 17 cases, who had been follow-up for more than 5 years, were retrospectively analyzed, by which the clinical pathological type, operative approach and the postoperative recurrence were studied. RESULTS There were 13 cases of monocystic and 4 cases of multicystic orr solid varieties. Conservative surgery was performed in 7 cases with 3recurrences; while radical resection was conducted in 10 cases with 1 recurrence. Free vascular fibular flap was used in two cases to reconstruct the defect of the mandible. All 4 recurrent cases were monocystic, of which conservative approach was applied in 3 cases. CONCLUSION Thorough removal of tumor is crucial in reducing recurrence. However, radical resection results in more difficulty in reconstruction of the contour and function of the mandible. Hence, many factors including the patients＇demand, the tumor size, etc should be taken into account in order to choose the proper operative procedure.

关 键 词：成釉细胞瘤 治疗结果 骨移植 下颌骨成釉细胞瘤 回顾性分析 瘤治疗 术后复发率 保守性手术 根治性手术 血管化游离 

分 类 号：R739.82[医药卫生—肿瘤]