背景:成釉细胞瘤(AM)是最常见的良性牙源性肿瘤,在下颌骨比上颌骨更常见,尤其是下颌体和下颌角。小儿AM是一种罕见的疾病,尤其是10岁及以下的患者。与成人成釉细胞瘤的主流截骨和重建手术相比,小儿成釉细胞瘤的治疗还有更多的讨论空间。术后功能和心理影响不容忽视。特别是对于处于生长发育时期的儿童,截骨术通常很难被父母接受。我们报告了两名10岁以下的成釉细胞瘤患者,他们接受了刮治和开窗术治疗,这对成釉细胞瘤儿童是一种有益的方法。
方法:我们介绍了2例儿童经典成釉细胞瘤。我们详细描述了患者的特征,处理过程,和后续结果。每次临床检查均记录开窗减压和刮除后病变区域的骨形成和重建。还描述和讨论了刮宫和减压的手术细节和原则。两组患者骨形状恢复较好,无复发。
结论:儿童正处于生长发育时期,具有极强的骨形成和重建能力。基于微创和功能保存的原则,我们认为,刮宫联合减压可以作为治疗儿童AM的首选,尤其是下颌骨病变。
BACKGROUND: Ameloblastoma (AM) is the most common benign odontogenic tumor, which is more often detected in the mandible than maxilla, especially the mandibular body and mandibular angle. Pediatric AM is a rare disease, especially in patients aged 10 and younger. Compared with the mainstream osteotomy and reconstructive surgery for adult ameloblastoma, there is more room for discussion in the treatment of pediatric ameloblastoma. The postoperative functional and psychological influence can not be ignored. Especially for children in the period of growth and development, an osteotomy is often challenging to be accepted by their parents. We report two patients with ameloblastoma under 10 years old who are treated with curettage and fenestration, which is a beneficial method for children with ameloblastoma.
METHODS: We present two cases of classic ameloblastoma in children. We describe in detail the patients\' characteristics, treatment processes, and follow-up result. The bone formation and reconstruction in the lesion area after fenestration decompression and curettage are recorded at every clinic review. The surgical details and principles of curettage and decompression are also described and discussed. The two patients have good bone shape recovery and no recurrence.
CONCLUSIONS: Children are in the growth and development period and possess an extremely strong ability of bone formation and reconstruction. Based on the principles of minimally invasive and functional preservation, we believe that curettage combined with decompression can be the first choice for treating AM in children, especially for mandibular lesions.