PDF(Pubmed)
Abstract：
Ossifying fibroma (OF) in craniofacial is a rare disease, benign, locally aggressive fibro-osseous tumor. The 2017 World Health Organization classifications divided OF into two types: OF of odontogenic origin and juvenile ossifying fibroma (JOF). Determining the right surgical treatment to reduce the postoperative recurrence rate is incredibly challenging. The author reports two cases of paranasal sinuses with disease onset progressed from pre-pubertal age. The first case is an example of a recurrent case after undergoing conservative surgery, and the second is a new one. All cases underwent radical surgery with subtotal maxillectomy and reconstructive surgery in one stage. After observing all patients until one year, there was no sign of recurrence through clinical and endoscopic examination. There are two types of surgery that compare in this case report: conservative surgery and radical surgery. Conservative surgical procedures include curettage, enucleation, or peripheral osteotomies. Several studies have shown high recurrence levels in OF patients when curettage or enucleation is performed; residue caused by incomplete excision is the most common reason that is easily caused by conservative surgery. Radical surgery such as open maxillectomy is a promising approach for degrading the level of recurrence. JOF, especially trabecular juvenile ossifying fibroma, shows a high recurrence percentage comparing other types. The first-choice management for treating OF was the surgical approach. Types of surgery depend on the disease\'s aggressiveness and morbidity. Radical surgery was proven better at decreasing recurrence level than conservative surgery.
摘要：
骨化纤维瘤（OF）在颅面是一种罕见的疾病，良性,局部侵袭性纤维骨性肿瘤。2017年世界卫生组织的分类分为两种类型：牙源性纤维瘤和青少年骨化性纤维瘤（JOF）。确定正确的手术治疗以降低术后复发率是非常具有挑战性的。作者报告了两例从青春期前开始发病的鼻旁窦。第一例是一例经过保守性手术后复发的病例,第二个是新的。所有病例均行根治性手术，上颌骨次全切除术和重建手术。在观察所有患者直到一年后，通过临床和内镜检查均无复发迹象.在这种情况下，有两种类型的手术比较：保守性手术和根治性手术。保守的外科手术包括刮宫术,摘除,或外周截骨术。一些研究表明，进行刮治或摘除术时，OF患者的复发率很高；不完全切除引起的残留是最常见的原因，很容易由保守手术引起。根治性手术如开放上颌骨切除术是降低复发水平的一种有前途的方法。JOF,尤其是幼年骨化纤维瘤，与其他类型相比，显示较高的重复百分比。治疗OF的首选方法是手术方法。手术类型取决于疾病的侵袭性和发病率。根治性手术在降低复发水平方面比保守性手术更好。
