摘要
齒源性角化囊腫乃起源於牙釉器官或是牙板的發育性囊腫。在所有下顎囊腫中，它大約佔了百分之十一，常發生在下顎骨角與下顎枝處。角化囊腫擁有明顯的組織病理表徵，且以局部侵襲性和特高再發率著稱。其治療方式有造袋術，造袋術後摘除術，摘除術，邊緣切除術和分截切除術等。本文報導一27歲男性，其左側下顎骨角與下顎枝處罹患齒源性角化囊腫，進行了兩次手術，首次由口外做摘除術及周圍骨去除術。於八年後追蹤時完全復發，且比原來的範圍大，第二次只施予造袋術。再經過八年追蹤發現，角骨及下顎枝處完全復原，只見左下方小臼齒區，仍有小小的復發，再施以摘除術伴隨冷陳治療。此病例歷經十六年長期追蹤，於此期間採取兩種不同的治療術式，卻產生截然不同的結果，雖然有小範圍的復發，都能輕易地再給予摘除。因其再發率特高，長期的追蹤是必須的，故提此報告。
並列摘要
The odontogenic keratocyst (OKC) is classified as a developmental cyst that derived from the enamel organ or the dental lamina. It comprises approximately 11%of all cysts of jaw. The cysts are most often seen in the mandibular ramus or angle. Keratocysts have a distinct histopathological appearance and are known to be locally aggressive and have a high recurrence racurrence rate thus requiring close long-term follow-up Treatment of the odontogenic keratocysts remains a controversial subject. Treatment modalities include simple marsupialization, marsupialization follower by enucleation, enucleation with cryotherapy, readical enucleation and segmental mandible resection. This paper presented a case that had been followed for 16 years. It had been treated by an aggressive surgery (radical enucleation and peripheral ostectomy) at the first time, with evidence of recurrence 8 years later. The recurrent lesion was then treated with a conservative surgery (marsupialization) and yield a satisfactory result. After another 8-year period follow-up, two small recurrences were noted and were easily enucleated.
延伸閱讀
- 徐維宏、張簡于瑄、林瑩澤（2020）。齒源性皮膚瘻管：病例報告。臺灣兒童牙醫學雜誌，20(3)，125-129。https://doi.org/10.6319/TJPD.202009_20(3).0006
- 康家郡、于錫倩、楊于萱、林哲毅（2013）。疑似源自齒源性角化囊性瘤的原發性顎骨內鱗狀細胞癌－病例報告。臺灣口腔顎面外科學會雜誌，24(4)，265-276。https://www.airitilibrary.com/Article/Detail?DocID=a0000494-201312-201401210028-201401210028-265-276
- 張映紅、陳郁婷、陳宛君、林益弘、盧俊泰（2014）。周圍性齒瘤－病例報告。中華民國家庭牙醫學雜誌，9(3)，14-18。https://doi.org/10.6566/JFD/2014.9(3).14
- 胡宥瑄、黃于真、蔡蔭玲、張佩菁（2011）。齒源性囊腫之造袋術治療─病例報告。臺灣兒童牙醫學雜誌，11(3)，76-79。https://doi.org/10.6319/TJPD.2011.11(3).5
- Liu, T. L., Kuo, Y. J., Kuo, C. C., Lui, M. T., Kao, S. Y., & Lo, W. L. (2018). 下顎犬齒區齒源性角化囊腫－病例報告與文獻回顧. 臺灣口腔顎面外科學會雜誌, 29(2), 134-141. https://www.airitilibrary.com/Article/Detail?DocID=a0000494-201806-201807310018-201807310018-134-141