METHODS: Odontogenic cysts with lesion sizes ranging 2-4 cm were included. The clinical and radiological data of the patients were reviewed. Decompression-first and direct enucleation treatments were the two main surgical techniques. The preoperative parameters and postoperative outcomes were compared between the two groups.
RESULTS: Out of 69 patients included, 40 (58 %) were in the decompression group and 29 (42 %) in direct enucleation group. The logistic regression analysis of preoperative parameters demonstrated that the maximum lesion size and the chief surgeon\'s preference could affect the selection of surgical techniques for medium-sized cysts (P < 0.05). Receiver operating characteristic curve analyses demonstrated that a lesion size >2.5 cm was the best cutoff value for predicting a decompression selection. Most postoperative outcomes differed significantly between the two groups (P < 0.05). Lower-risk anesthesia, shorter hospitalization, tooth function protection, and fewer neurosensory impairments were decompression-favoring outcomes. However, more follow-up visits, more postoperative X-rays, and longer postoperative care were outcomes against decompression. The recurrence rate was low and did not differ significantly between the two groups (P > 0.05).
CONCLUSIONS: There is no apparent preference for treating medium-sized jaw cysts. The maximum lesion size is a moderate-impact factor for treatment selection. A tendency to prefer decompression-first with larger lesion size was found in medium-sized jaw cysts. The advantages of teeth preservation and low neurosensory impairment of decompression were verified in the medium-size jaw cysts. The burden of postoperative care should be considered when selecting decompression.
方法:包括病变大小为2-4cm的牙源性囊肿。回顾了患者的临床和放射学数据。先减压和直接摘除术是两种主要的手术技术。比较两组患者术前参数及术后结局。
结果:包括69例患者,减压组40例(58%),直接摘除组29例(42%)。术前参数的logistic回归分析显示,最大病灶大小和主刀医师的选择会影响中型囊肿手术技术的选择(P<0.05)。接收器工作特征曲线分析表明,病变大小>2.5cm是预测减压选择的最佳截止值。两组患者术后大部分结局差异有统计学意义(P<0.05)。低风险的麻醉,住院时间较短,牙齿功能保护,和较少的神经感觉障碍是减压-有利于结果。然而,更多的后续访问,更多的术后X光片,术后护理时间更长是减压的结果。两组复发率低,差异无统计学意义(P>0.05)。
结论:对于治疗中型颌骨囊肿没有明显的偏好。最大病变大小是治疗选择的中等影响因素。在中型颌骨囊肿中发现了倾向于先减压并较大病灶的倾向。在中型颌骨囊肿中验证了保留牙齿和减压的低神经感觉障碍的优势。选择减压时应考虑术后护理的负担。