Abstract：
BACKGROUND: The treatment of medium-sized odontogenic jaw cysts is inconsistent at present. Two main treatments, namely decompression and enucleation, are used overlappingly. This retrospective analysis aims to provide useful references for technique selection for future management of medium-sized odontogenic jaw cysts.
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.
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.
摘要：
背景：目前，中型牙源性颌骨囊肿的治疗方法不一致。两种主要治疗方法，即减压和摘除，重叠使用。这项回顾性分析旨在为将来中型牙源性颌骨囊肿的治疗技术选择提供有用的参考。
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。
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。
