2种开窗减压术治疗大型下颌骨牙源性囊肿的效果比较

Comparison of two different decompression procedures for treating large mandibular odontogenic cysts

目的:探讨2种不同开窗减压术对大型下颌骨牙源性囊肿预后的差异。方法:选择93例大型下颌骨牙源性囊肿患者,根据开窗减压术方式不同,分为囊壁去除组(51例)和囊壁保留组(42例)。比较术后1年剩余囊腔面积、体积及囊腔区域密度变化。结果采用Prism 7.0软件进行统计学分析。结果:术后1年,囊壁去除组囊腔面积、囊腔体积、原囊腔区域HU值与对侧正常颌骨HU值的差异相对于囊壁保留组为非劣效。亚组分析显示,囊腔面积缩小90%所占比例在2组间无显著差异,但术后1年囊腔区域HU值的变化,囊壁去除组明显优于囊壁保留组。此外,囊壁去除组在不发生复发的前提下仅需要一次手术,避免了患者二次手术的创伤和痛苦。结论:囊壁去除比囊壁保留在大型下颌骨牙源性囊肿的开窗减压手术治疗中可能有更好的临床效果。

PURPOSE:To explore the differences in the prognosis of two different types of decompression procedures for treating large mandibular odontogenic cysts.METHODS:This retrospective cohort study included 93 patients with large mandibular odontogenic cysts,and divided into wall removal group(51 cases)and wall retaining group(42 cases)according to different methods of decompression.Cyst area,volume,HU values and cyst density were compared.The results were analyzed using Prism 7.0 software.RESULTS:After 1 year,the wall removal group was not inferior to the wall retaining group in terms of cyst area,cyst volume,and the difference between the HU values of the original cyst region and the normal mandible.In subgroup analysis,there was no significant difference between the two groups in percentage of patients in whom the cystic area was reduced by 90%after 1 year.However,changes in HU values in the wall removal group were significantly better than those in the wall retaining group.More importantly,patients underwent only one operation in wall removal group if there was no recurrence,which improved the quality of life and reduced the financial burden.CONCLUSIONS:The results suggest that cyst wall removal group showed better results than cyst wall retaining group in large mandibular odontogenic cysts.