以勒福一式骨切開途徑切除上顎竇後緣之齒源性病灶－四病例報告

手術剜除或減壓後為剜除是目前處理顎骨囊腫之普遍療法，但若病灶位於難以操作之部位時，將使前述治療方式受限。勒福一式骨切開術於上顎骨先天或發育異常之矯正早已應用廣泛，然而自1986年起才陸續有將此術式用於移除顱底或中臉部腫瘤之記載。本文用圖文呈現四例以此術式切除位於上顎竇最後、最深處之齒源性病灶及其後續追蹤狀況。前兩例為女性病人，均先經減壓手術後，再切除病灶；第三例(20歲女性)及第四例(47歲男性)則未經減壓而直接手術切除。由於勒福一式骨切開術提供良好手術視野及有效操作途徑，利於完全移除病灶；手術所造成之骨缺損亦比考德威爾呂克術式少；截骨處的復位與固定方式、術後傷口照護及飲食限制，則比照一般正顎手術病例為之；追蹤顯示咬合位置不變、咀嚼功能正常。

關鍵字

勒福一式骨切開術；齒源性囊腫；齒源性腫瘤；考德威爾呂克術式

並列摘要

Enucleation alone and marsupialization (Partsch operation) followed by enucleation have been the most common modalities for complete eradication of jaw bone cysts. However, it is sometimes difficult to do so when the lesion's location was not easily accessed. Although Le Fort I osteotomy is a well known procedure for correction of dentofacial deformities, it has also been applied in removal of skull base and mid-face tumors by cranio-maxillofacial surgeons since 1989. We'd like to present 4 cases of surgical excision of benign odontogenic lesions near posterior maxillary sinus wall using Le Fort I approach. The first one is a 18 y/ o lady who suffered from recurrent keratocystic odontogenic tumor (KCOT) at R't posterior maxilla after conservative Partsch-I & II operation. The second one is a 24 y/o female with recurrent infection of dentigerous cyst at R't posterior maxilla after Partsch-I operation. The third one (20 y/o female) and the fourth one (47 y/o male) were dentigerous cyst at posterior maxillary area, both surgically removed without preceding Partsch operation. This approach offered clear surgical field and effective access to help complete removal of pathologic lesions. Routine plate fixation at canine pillar / zygomatic buttress and application of short term light guiding elastics rendered uneventful healing of osteotomy sites and stable occlusion with minimal postoperative morbidities.

並列關鍵字

Le Fort I osteotomy ； Odontogenic cyst ； Odontogenic tumor ； Caldwell Luc's approach

國際替代計量

以勒福一式骨切開途徑切除上顎竇後緣之齒源性病灶－四病例報告

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