Dentigerous Cyst in the Maxillary Sinus with an Ectopic Tooth-Case Review

上顎竇之含齒囊腫以及異位牙－病例報告

陳人瑄(Jen-Hsuan Chen) ； 陳萬宜(Man-Yee Chen)

《臺灣口腔顎面外科學會雜誌》 24卷4期 (2013/12) Pp. 289-298

摘要

含齒囊腫是一種囊腫具有上皮覆蓋它是由形成牙齒器官的殘餘所衍生出來的，是第二個最常見齒源性囊腫。含齒囊腫是最常見的區域下顎骨體以及其上升枝，大部份可能無臨床症狀。然而，發生在上顎竇，可能會表現出各式各樣的臨床症狀。減少術後併發症的前提下，治療計畫的擬定是困難的。為了了解和成功的治療在這個特殊解剖位置的含齒囊腫。台中榮民總醫院口腔顎面外科從2000年至2010年間收集七位病例。結果發現，患者通常表現出的症狀包括腫脹，慢性鼻竇炎和口竇瘻管。環口攝影和電腦斷層被用來診斷和追蹤這些個案。電腦斷層更容易觀察囊腫和牙齒的位置。主要的治療方法囊腫摘除以及牙齒拔除，最常見的副作用是口竇瘻管的形成。我們相信，早期發現和清除異位上顎竇囊腫是很重要，因為術後的病發症發生率較低。因此早期影像學檢查提早發現和適當轉診提早治療是相當重要的。

關鍵字

含齒囊腫 ； 上顎竇 ； 鼻竇炎 ； 牙齒異位萌發

並列摘要

Dentigerous cyst has an epithelial lining that is derived from the epithelial remnants of the tooth-forming tissue and it is the second most common type of an odontogenic cyst. Dentigerous cysts are most frequently found in the mandibular body and ascending ramus and are asymptomatic in most cases. However, if found in the maxillary sinus, these cysts may demonstrate a wide range of signs and symptoms. Treatment is difficult because of the effort to prevent and minimize post-operative complications. To understand and successfully treat dentigerous cysts located in these particular regions, we collected and reviewed seven cases from the Oral and Maxillofacial Surgery Department of Taichung Veterans General Hospital between 2000 and 2010. It was found that patients usually presented with symptoms that included swelling, chronic sinusitis and fistulas. Panoramic radiography and three-dimensional images were used to diagnose and follow-up on these cases. The location of the cysts as well as teeth were easily identifies on the threed-imensional images. The primary treatment involved enucleation, and development of an oroantral fistula was the most commonly observed side effect. We believe that early detection and removal of the ectopic maxillary sinus cyst are necessary and should be undertaken as soon as possible. Thus, we believed that radiographic survey and appropriate referral for treatment should become common practice.

並列關鍵字

dentigerous cyst ； maxillary sinus ； sinusitis ； ectopic tooth