Staged protocol for resection, skeletal reconstruction, and oral rehabilitation of children with jaw tumors
Staged protocol for resection, skeletal reconstruction, and oral rehabilitation of children with jaw tumors
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DOI：
10.1016/j.joms.2003.07.006
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发表时间：
2004-03-01
影响因子：
1.9
通讯作者：
Kaban, LB
中科院分区：
文献类型：
--
作者：
Troulis, MJ;Williams, WB;Kaban, LB
目的：本研究的目的是评估一个阶段的协议颌骨肿瘤切除和重建，包括植入物在儿科patients.Patients和方法：9名儿童进行了回顾性评价。数据包括切除时的年龄、肿瘤类型、辅助治疗的使用、植骨类型和植入物数量。发生术后感染，肿瘤边缘，复发，板骨折，骨移植，种植体恢复，失败的数量recorded.Results：年龄范围从3.5至16岁，2上颌和7下颌肿瘤。诊断包括巨细胞病变（n = 3），骨肉瘤（n = 2），肌纤维瘤（n = 1），骨化性纤维瘤（n = 1），促结缔组织增生性纤维瘤（n = 1）和成釉细胞瘤（n = 1）。整块切除术后，无患者发生术后感染、伤口裂开或颌骨不稳定。1例患者巨细胞病变复发。迄今为止（平均56个月;范围24至93个月），没有额外的复发。有1例接骨板断裂。8例患者接受髂骨移植（2期），1例患者下颌骨再生。无移植物感染或伤口裂开。3名患者需要额外植骨以植入种植体。7例患者植入23枚种植体，无并发症，21枚种植体进入二期。1个种植体未能骨整合。6例患者植入假体并负重平均26个月（范围：5 - 64个月）。结论：儿童颌面部肿瘤采用切除、坚强内固定、延期重建等方法治疗，并发症少，成功率高。(C)2004年美国口腔颌面外科医师协会。
Purpose: The purpose of this study was to evaluate a staged protocol for resection of jaw tumors and reconstruction including implants in pediatric patients.Patients and Methods: Nine children were evaluated retrospectively. Data included age at resection, tumor type, use of adjuvant therapy, type of bone graft, and number of implants. Occurrence of postoperative infection, tumor margins, recurrence, plate fractures, number of bone grafts, implants restored, and failures were recorded.Results: Ages ranged from 3.5 to 16 years with 2 maxillary and 7 mandibular tumors. Diagnoses included giant cell lesion (n = 3), osteosarcoma (n = 2), myofibroma (n = 1), ossifying fibroma (n = 1), desmoplastic fibroma (n = 1), and ameloblastoma (n = 1). No patients experienced postoperative infection, wound dehiscence, or jaw instability after en bloc resection. One patient had recurrence of a giant cell lesion. To date (mean, 56 months; range, 24 to 93 months), there have been no additional recurrences. There was 1 plate fracture. Eight patients underwent iliac bone grafts (stage 2), and in I patient, the mandible regenerated. There were no graft infections or wound dehiscences. Three patients required additional bone grafting for implant placement. Twenty-three implants were placed in 7 patients without complications, and 21 implants have gone to second stage. One implant failed to osseointegrate. Six patients have had prostheses placed and loaded for a mean of 26 months (range, 5 to 64 months). one patient is scheduled for prosthetic restoration and 2 for implant placement.Conclusion: Pediatric maxillofacial tumors can be successfully treated by resection, rigid fixation, and delayed reconstruction with minimal morbidity and a high success rate. (C) 2004 American Association of Oral and Maxillofacial Surgeons.