- 期刊
兒童造釉細胞瘤臨床研究
A Clinical Study of Ameloblastoma in Children
摘要
研究目的：探討顎骨造釉細胞瘤在台灣兒童的臨床表現、病理變化、治療方法與預後之特殊性，以供臨床與研究參考。 材料與方法：選擇1990至2004年問，首次罹忠顎骨造釉細胞瘤，且年齡在18歲以下，在高雄醫學大學附設中和紀念醫院口腔顎面外科接受治療的病患，記錄其年齡、性別、初步診斷、臨床分類、病理組織學的型態、部位、腫瘤大小、侵犯周邊組織的程度與範圍、放射線檢查的特徵、涉及的牙齒、治療方式、住院時間、後遺症與復發情形等，進行統計分析。 結果：總共有15位病人，男性9位，女性6位。平均年齡13.4歲，10歲以下的只有一位。發生部位以下顎後牙區較多（13位），侵犯上顎與下顎聯合區各有一位。組織學表現以叢狀型6例最多，棘狀型4例居次。病灶大小從4至9公分。手術治療方式包括刮除術或摘除術5位，摘除術加上骨修磨術6位，骨部分切除與骨移植術4位。有3位(20%)病人復發，平均術後復發時間為4年（3年到6年）。 結論：在手術方法方面，本研究發現，不論何種形態的造釉細胞瘤，保守性治療，再發的機率並無升高，但對病人的美觀、功能、發育和心理上的影響都比較小。
並列摘要
The purpose of this study was to describe the clinical characteristics of ameloblastoma in adolescents and children in Taiwan, to know the differences between children and adults and to compare with the results with the studies of other countries.. From the records of the Department of Oral and Maxillofacial Surgery at Kaohsiung Medical University Chung-Ho Memorial Hospital, there were 15 patients under the age of 18 with histologically diagnosed ameloblastoma from 1990 to 2004. The parameters extracted from the case file included age at presentation, gender, symptoms, duration of symptoms, treatment before presentation, anatomic location and extent, radiographic features and embedded teeth, histological type, treatment, recurrence and follow up. There were 9 males and 6 females. The average age was 13.4 years old with 1 patient under 10 years old. There were 6 patients with plexiform type and 4 with acanthomatous type. The size of lesion was 4 to 9 centimeters. All patients received surgical treatment. There were 5 patients treated with curettage or enucleation only, 6 with enucleation and adequate peripheral ostectomy, 4 patients with segmental resection and immediate reconstruction with iliac bone graft. Three of them (20%) had recurrence. Compared with the studies of other countries, this study only showed the differences in rates of patients' gender and unicystic occurrence. We found that conservative treatment could give acceptable result in all types of cystic ameloblastoma with less impact to the masticatory function, appearances, and development of children.