3.8 Article

A case of extremely rare mandibular osteoblastoma successfully treated with functional reconstruction

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ELSEVIER SCIENCE INC
DOI: 10.1016/j.ajoms.2023.06.004

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Osteoblastoma; Segmental mandibulectomy; Functional reconstruction; Particulate cancellous bone and marrow; (PCBM); Nerve conduit

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Osteoblastoma is a rare bone tumor that often occurs in the maxillofacial region, primarily the posterior mandible. Swelling and pain are common symptoms, but some cases are asymptomatic. Diagnosis can be challenging due to similarities with other diseases. Complete resection is the preferred treatment.
Osteoblastoma is a benign bone-forming tumor. It accounts for less than 1 % of all bone tumors, and approximately 10 % of osteoblastoma occurs in the maxillofacial region, most commonly the posterior mandible. Swelling and pain are common symptoms of osteoblastoma, but some cases are asymptomatic. The diagnosis may be difficult considering that diseases exist similar to osteoblastoma in clinical, radiological, and pathological findings. Due to its local invasiveness, complete resection is the preferred treatment. Here, we report a case of relatively large mandibular osteoblastoma in a 22-year-old woman that was difficult to diagnose. Since she was a young woman, considering early postoperative functional recovery and quality of life, we performed segmental mandibulectomy, mandibular reconstruction with a titanium mesh tray, and an autogenous iliac particulate cancellous bone and marrow (PCBM). We performed inferior alveolar nerve reconstruction using a nerve conduit made of a polyglycolic acid-collagen (PGA-collagen) tube. The postoperative course was uneventful. Neurosensory disturbance of the mental nerve improved 4 months after surgery, and normal status was recovered after 1 year. Furthermore, 1 year after surgery, dental implants were placed for occlusal restoration. As of the time of this report, 2 years and 6 months had passed since the operation, and there were no obvious abnormalities.

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