复发性牙源性角化囊肿刮除及冷冻治疗的效果评价  

Treatment of recurrent odontogenic keratocyst with enucleation and cryosurgery: A retrospective study of 10 cases

作　　者：周景兰 焦顺利 陈晓华 王玉磊 

机构地区：[1]山东省淄博市第一医院口腔科,山东淄博255200

出　　处：《上海口腔医学》2005年第5期476-478,共3页Shanghai Journal of Stomatology

摘　　要：目的:探讨颌骨角化囊肿术后复发的刮除及冷冻治疗效果。方法:1994～2004年间,对10例颌骨角化囊肿术后复发病例,采用囊肿刮除联合冷冻治疗。冷冻方法为直接接触法,即刮除囊壁后,用血管钳将蘸有液氮的棉球送入囊腔,对囊腔骨壁进行冷冻;冷冻时间一般为3～5min,冻融3个周期。治疗后随访5～10a,定期进行临床及X线检查,评价治疗效果和并发症。结果:10例颌骨角化囊肿术后复发患者,经刮除及冷冻治疗后,效果良好,随访期内均无复发。1例因冻伤周围软组织,伤口延期愈合;1例发生下颌骨病理性骨折,经颌间结扎处理,骨折愈合。结论:颌骨角化囊肿术后复发应用刮除及冷冻治疗,远期效果良好,复发率低,减少了以往截骨手术的痛苦,患者容易接受,具有临床推广价值。PURPOSE： Tu evaluate the clinical outcomes of treatment of recurrent odontogenic keratocyst with enucleation and cryosurgery in 10 consecutive cases. METHODS： 10 patients with recurrent odontogenic keratocyst of the jaw were treated with enucleation and liquid nitrogen cryosurgery between 1994 and 2000. After enucleation of the cystic lining, liquid nitrogen （-196℃） was applied to the bony walls via cotton rolls for cryosurgery. The time for cryosurgery was between 3 to 5 minutes with 3 cycles of freeze and thaw. All the patients were followed up for 5 to 10 years after treatment with regular clinical and radiographic examinations. Postoperative complications and the final outcomes were evaluated. RESULTS： No recurrence was noted within the follow-up period after combined treatment of enucleation and cryosurgery. Secondary wound healing developed in 1 patient due to accidental freezing of the adjacent tissues, and pathologic fracture of the mandible occurred in 1 patient. The fracture healed secondarily with intermaxillary fixation. CONCLUSION： Based on these results, the combination of enucleation and liquid nitrogen cryotherapy offers patients improved therapy in the management of recurrent ndontogenie keratocysts of the jaw, with lower recurrence and avoidance of osteetomy, which is likely to be accepted by the patients.

关 键 词：颌骨角化囊肿 复发 刮除术 冷冻治疗 

分 类 号：R782[医药卫生—口腔医学]