Journal of Oral and Maxillofacial Surgery Medicine and Pathology最新文献_第3页

TCR repertoire analysis reveals predominant local clonal expansion of T cells with minimal circulation in oral lichenoid contact lesions TCR曲目分析显示，口腔地衣样物质接触性病变中，主要是局部克隆扩增的T细胞，循环最小

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology

Pub Date : 2025-08-23 DOI: 10.1016/j.ajoms.2025.08.005

Naoto Nishii , Fumihiko Tsushima , Jinkyo Sakurai , Yuya Su , Naoya Kinoshita , Yu Oikawa , Yosuke Hirotsu , Toshimitsu Ohsako , Emi Furusawa-Nishii , Masao Omata , Hiroyuki Harada

Objective

Oral lichenoid contact lesions (OLCLs) are inflammatory oral mucosal disorders triggered by hypersensitivity to dental metals and resemble oral lichen planus (OLP) clinically and histologically. The T-cell receptor (TCR) repertoire in lesions reflects the type and frequency of the antigen; however, the details of the TCR repertoires of OLCLs have never been reported. The aim of this study was to evaluate the presence of clonally expanded T cells within the lesion tissue and peripheral blood of OLCL, and to determine whether differences exist between these compartments.

Methods

We analyzed TCR repertoires in lesion tissues from nine OLCL patients and peripheral blood from five of these patients using high-throughput next-generation sequencing. V–J gene usage, and complementarity-determining region 3 clonotypes were examined to detect antigen-driven clonal expansions.

Results

All OLCL lesions exhibited clonally expanded T-cell populations, with dominant clones exceeding 1 % frequency. These large expanded clones were predominantly localized within lesion tissues and were either absent or found at very low frequencies in peripheral blood. In one patient, an identical expanded clone was detected in two separate OLCL lesions contacting metal prostheses but was undetectable in blood.

Conclusion

Our study demonstrates that OLCL lesions harbor clonally expanded T cells that remain primarily localized within the tissue and are largely absent from peripheral blood. This distribution pattern supports the hypothesis that resident memory T cells responding to metal-related antigens may contribute to disease pathogenesis.

目的口腔类地衣接触病变（OLCLs）是一种由口腔金属过敏引起的炎症性口腔黏膜疾病，在临床和组织学上与口腔扁平苔藓（OLP）相似。病变中的t细胞受体（TCR）库反映了抗原的类型和频率；然而，olcl的TCR谱的细节从未被报道过。本研究的目的是评估OLCL病变组织和外周血中是否存在克隆扩增T细胞，并确定这些区室之间是否存在差异。方法采用高通量新一代测序技术对9例OLCL患者病变组织和其中5例患者外周血中的TCR谱进行分析。检测V-J基因的使用和互补决定区3克隆型，以检测抗原驱动的克隆扩增。结果所有OLCL病变均表现出克隆扩增的t细胞群，优势克隆频率超过1 %。这些大型扩增克隆主要局限于病变组织内，在外周血中要么不存在，要么频率很低。在一名患者中，在接触金属假体的两个单独的OLCL病变中检测到相同的扩展克隆，但在血液中检测不到。结论：我们的研究表明，OLCL病变中存在克隆扩增的T细胞，这些细胞主要局限于组织内，并且在外周血中基本不存在。这种分布模式支持了对金属相关抗原有反应的常驻记忆T细胞可能参与疾病发病机制的假设。

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引用次数: 0

Airway management in unexpected tracheal bronchus detected during tracheostomy: A case report 气管切开术中发现意外气管支气管的气道处理：1例报告

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology

Pub Date : 2025-08-22 DOI: 10.1016/j.ajoms.2025.08.011

Chihiro Niimi , Nanako Hirabayashi , Masao Kurosaka , Shota Tsukimoto , Masashi Yamashiro , Takami Komatsu , Hidetaka Kuroda

Tracheal bronchus is a rare congenital anomaly characterized by an aberrant bronchus originating directly from the trachea. Although typically asymptomatic, it can significantly affect airway management during anesthesia. Here, we report a case of tracheal bronchus first detected during tracheostomy and propose strategies for safe daily airway management. A 68-year-old man underwent a tracheostomy under general anesthesia for mandibular tumor resection. Following oral intubation, replacing the endotracheal tube with a tracheostomy tube led to insufficient ventilation. An unexpected abnormal bronchus is detected during bronchoscopy. Ventilation was restored, and safe airway management was achieved by switching the type and depth of the tracheal tube. This case highlights the importance of considering a tracheal bronchus when unexpected ventilation difficulties arise during airway management. Tracheal abnormalies should always be suspected when inadequate ventilation and oxygenation are encountered after intubation, and bronchoscopy is useful for confirmation.

气管支气管是一种罕见的先天性异常，其特征是异常支气管直接起源于气管。虽然通常无症状，但它可以显著影响麻醉期间的气道管理。在此，我们报告一例在气管造口术中首次发现气管支气管的病例，并提出安全的日常气道管理策略。68岁男性在全身麻醉下行气管切开术切除下颌骨肿瘤。经口插管后，用气管造口管代替气管内管导致通气不足。支气管镜检查发现意外异常支气管。通过切换气管管的类型和深度，恢复了通气，实现了安全的气道管理。本病例强调了在气道管理过程中出现意外通气困难时考虑气管支气管的重要性。当气管插管后出现通气和氧合不足时，应始终怀疑气管异常，支气管镜检查有助于确认。

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引用次数: 0

Dentinogenic ghost cell tumor invading the maxillary sinus: A rare case report with a review of the literature 牙本质源性鬼细胞瘤侵袭上颌窦：一例罕见病例报告并复习文献

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology

Pub Date : 2025-08-22 DOI: 10.1016/j.ajoms.2025.08.012

Pawat Sripodok , Pornpattra Chulamanee , Atsumu Kouketsu , Yutaro Higashi , Tomonari Kajita , Tsuyoshi Kurobane , Yuta Yanagisawa , Tsuyoshi Sugiura , Hiroyuki Kumamoto

Dentinogenic ghost cell tumor (DGCT) is a rare, locally aggressive odontogenic neoplasm. This report presents the case of an 80-year-old female with DGCT involving the left maxilla and maxillary sinus. Orthopantomography radiography revealed a well-defined radiopaque lesion in the left posterior maxilla, while Waters’ view demonstrated an irregular radiopaque mass with mixed radiolucent and radiopaque features in the maxillary sinus. Advanced imaging, including CT, confirmed the mass extending into the maxillary sinus and adjacent structures. Histopathological examination of the biopsy indicated DGCT, characterized by ameloblastoma-like epithelium, ghost cells, and dentinoid formation. The patient underwent partial resection of the left maxilla. Immunohistochemistry revealed positive staining for β-catenin, bcl-2, and p63, with a 15 % Ki-67 expression. At 26 months postoperatively, the patient showed no signs of recurrence. A review of the literature identified 13 cases of DGCT with maxillary sinus involvement since 2000, revealing a recurrence rate of approximately 60 % and a potential risk of malignant transformation into ghost cell odontogenic carcinoma. Recurrence was commonly observed in cases treated conservatively, likely due to initial misdiagnosis as a calcifying odontogenic cyst based on incisional biopsy findings, along with challenges related to maxillary sinus involvement. Given the aggressive nature of DGCT, we advocate for surgical resection with long-term follow-up to reduce the risk of recurrence and malignant transformation.

牙本质鬼细胞瘤是一种罕见的局部侵袭性牙源性肿瘤。本报告报告一例80岁女性DGCT累及左上颌及上颌窦。正体层析x线片显示左侧后上颌一清晰可见的不透明病变，而Waters示上颌窦不规则不透明肿块，混合透光和不透明特征。包括CT在内的高级影像学证实肿块延伸至上颌窦及邻近结构。活检组织病理学检查显示DGCT，特征为成釉细胞瘤样上皮，鬼影细胞和牙本质样形成。病人接受了左上颌骨的部分切除。免疫组织化学显示β-catenin、bcl-2和p63阳性染色，Ki-67表达率为15% %。术后26个月，患者无复发迹象。我们回顾了2000年以来13例DGCT伴上颌窦病变的文献，发现复发率约为60% %，并有恶性转化为鬼细胞牙源性癌的潜在风险。保守治疗的病例通常观察到复发，可能是由于最初误诊为基于切口活检结果的钙化牙源性囊肿，以及与上颌窦受累性相关的挑战。鉴于DGCT的侵袭性，我们主张手术切除并长期随访，以降低复发和恶性转化的风险。

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引用次数: 0

An ectopic mandibular third molar with inflammatory gubernaculum dentis migrated beyond the inferior edge: A case report 下颌骨第三磨牙异位伴炎根带牙移出下缘1例

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology

Pub Date : 2025-08-19 DOI: 10.1016/j.ajoms.2025.08.008

Yuki Nagata , Katsuhiko Amano , Yu Tokushige , Shohei Tamura , Seiko Takeda , Seiji Iida

In oral surgery, impacted mandibular third molars are subjected to routine extractions. However, ectopic mandibular third molars (EMTMs) severely displaced are seen in a few cases. EMTMs are often accompanied with some lesions of odontogenic cysts and tumors which cause the severe dislocation as they grow. Here, we present a rare case of EMTM indicating deep impaction and distal migration in the absence of odontogenic lesions, and demonstrate the surgical treatment using both intra and extraoral approach. The patient was a 58-year-old Japanese female having a severely displaced left mandibular third molar. The EMTM was found to be with apical/periapical periodontitis of the second molar. The imaging exam resulted in possible involvement of gubernaculum dentis (GD) which was a characteristic feature of linear radiolucent area between the two teeth. We planned and performed the extractions of the second and third molars by using intraoral and extraoral approach, respectively, under general anesthesia. The specimen was inflammatory granulation tissue of impaired GD. The prognosis was free of unfavorable symptoms. The involvement of GD should be considered as one of the candidate factors for odontogenic pathology when diagnosing EMTMs.

在口腔外科中，阻生下颌第三磨牙是常规拔牙的对象。然而，异位的下颌第三磨牙（EMTMs）严重移位是在少数情况下看到。EMTMs常伴有一些牙源性囊肿和肿瘤的病变，随着它们的生长会导致严重的脱位。在这里，我们报告了一例罕见的EMTM病例，在没有牙源性病变的情况下，显示了深度嵌塞和远端迁移，并展示了使用口内和口外入路的手术治疗。患者为58岁日本女性，左下颌第三磨牙严重移位。发现EMTM伴有第二磨牙根尖/根尖周牙周炎。影像学检查结果显示可能累及管骨牙（GD），这是两颗牙齿之间线性放射透光区域的特征。在全身麻醉下，我们计划并分别采用口内入路和口外入路拔除第二和第三磨牙。该标本为GD受损的炎性肉芽组织。预后无不良症状。在诊断EMTMs时，GD的累及应作为牙源性病理的候选因素之一。

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引用次数: 0

Treatment of OSAHS associated with skeletal class II dentofacial anomaly through sagittal mandibular osteogenic distraction of the bilateral branch and box genioplasty: A case report and systematic review 双侧矢状下颌支植骨牵张及盒状颏成形术治疗OSAHS伴骨ⅱ类牙面异常1例报告及系统回顾

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology

Pub Date : 2025-08-16 DOI: 10.1016/j.ajoms.2025.08.007

Pedro Tapia Contreras , Sofia Díaz Abarza , Florencia Jollán Peña , Christopher Reyes Araya , Jessica Zeballos Cofré

Introduction

Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a significant public health issue affecting 2 %–4 % of adults globally due to its high prevalence and underdiagnosis. It is characterized by airway obstruction, particularly in individuals with craniofacial abnormalities. Surgical interventions, such as mandibular distraction osteogenic (MDO) and maxillomandibular advancement, can correct these abnormalities and improve the airway.

Objective

The purpose of this study is to present a combination of surgical techniques: MDO by bilateral sagittal split osteotomy (BSSO) plus box genioplasty of the mandibular symphysis to optimize the increase in the anteroposterior airway as an initial treatment, before orthognathic surgery or as a definitive treatment in patients with OSAHS.

Methods

A systematic review, following PRISMA guidelines, was performed using searches in the MEDLINE/PubMed, Cochrane and Web of Science databases. Various variables were considered and presented comprehensively in tables and figures alongside a case report.

Results

Postoperative analyses demonstrated airway improvements in the 3, 6 and 9 months, with a final relapse of 19.8 % in B point, 30 % in pogonion and 19.6 % in the minimum cross-sectional area, respectively. Evaluations showed enhancements in clinical parameters such as saturation, AHI and polysomnographic in the ninth month.

Conclusion

MDO by BSSO plus box genioplasty in adult patients with OSAHS and class II skeletal dentofacial abnormalities significantly increase airway without bone relapse, suggesting an effective therapeutic option for this condition.

梗阻性睡眠呼吸暂停低通气综合征（OSAHS）是影响全球2 % -4 %成人的重大公共卫生问题，由于其高患病率和低诊断率。它的特征是气道阻塞，特别是在颅面异常的个体中。手术干预，如下颌牵张成骨（MDO）和上颌下颌推进，可以纠正这些异常和改善气道。目的本研究的目的是提出一种联合手术技术：双侧矢状劈开截骨（BSSO）联合下颌联合盒形成形术的MDO，以优化前后气道的增加，作为OSAHS患者的初始治疗，在正颌手术前或作为最终治疗。方法按照PRISMA指南，检索MEDLINE/PubMed、Cochrane和Web of Science数据库进行系统评价。考虑了各种变量，并在病例报告旁边的表格和数字中全面呈现。结果术后3、6、9个月气道改善，B点复发率分别为19.8 %、30 %、最小截面积复发率为19.6 %。评估显示临床参数如饱和度、AHI和多导睡眠图在第9个月有所改善。结论成年OSAHS伴II类牙面畸形患者行BSSO +盒型颏成形术后气道明显增加，且无骨复发，是一种有效的治疗方案。

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引用次数: 0

Observation of bone healing after Le Fort I osteotomy with tuberosity separation Le Fort I型截骨术合并结节分离术后骨愈合的观察

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology

Pub Date : 2025-08-15 DOI: 10.1016/j.ajoms.2025.08.001

Satoko Koeda , Atsushi Nakamura , Makiko Yamamura , Hiroki Akiyama , Sigeru Ishii , Shouhei Ogisawa , Tatsuo Shirota , Shuichi Nishikubo

Objective

This study aimed to examine bone healing after Le Fort I (LFI) osteotomy with tuberosity separation.

Methods

Twenty patients who had undergone maxillary advance and clockwise rotation for skeletal class III malocclusion were included. LFI osteotomy with tuberosity separation was performed on the patients. The osteotomized maxilla was fixed to the piriform rim using bioabsorbable plates and to the zygomatic buttress using titanium miniplates (thickness: 0.6 mm). Computed tomography (CT) images were taken after 2 months (T1) and > 10 months (T2) of surgery. The piriform rim, maxillary sinus anterior wall, zygomatic buttress, and maxillary tuberosity were evaluated on a four-point scale: bone resorption (−2), no bone contact (−1), bone contact (0), and bone continuity (1).

Results

The average total scores for each site were as follows: maxillary tuberosity, 0.5 ± 0.4 (T1) and 1.0 ± 1.2 (T2); zygomatic buttress, −0.6 ± 0.6 (T1) and 0.1 ± 0.9 (T2); maxillary sinus anterior wall, −0.9 ± −0.6 (T1) and −0.3 ± 2.0 (T2); and aperture piriform rim, −0.5 ± 0.8 (T1) and 0.9 ± 1.5 (T2). The score increased significantly at all sites at T2 (p < 0.001). The CT values in the tuberosity site were 347.6 ± 134.1 at T1 and 418.8 ± 161.4.

Conclusions

The maxillary tuberosity showed the earliest evidence of bone continuity.

目的观察Le Fort I （LFI）截骨术合并结节分离术后的骨愈合情况。方法选取20例经上颌顺时针旋转治疗骨骼III类错颌的患者。对患者行LFI截骨术并结节分离。将截骨的上颌骨用生物可吸收钢板固定在梨状缘上，用微型钛板（厚度0.6 mm）固定在颧支撑上。术后2个月（T1）和10个月（T2）分别取CT图像。梨状缘、上颌窦前壁、颧骨支撑和上颌结节以四分制进行评估：骨吸收（- 2）、无骨接触（- 1）、骨接触(0)和骨连续性(1)。结果各部位的平均总分如下：上颌结节，0.5 ± 0.4 （T1）和1.0 ± 1.2 (T2)；颧骨扶壁, −0.6±0.6 (T1)和0.1 ±0.9 (T2);上颌窦前壁，−0.9 ±−0.6 （T1）和−0.3 ± 2.0 (T2)；孔径梨状缘，±0.5 ± 0.8 （T1）和0.9 ± 1.5 （T2）。T2时各部位评分均显著升高（p <； 0.001）。结节部位T1时CT值为347.6 ± 134.1，T1时为418.8 ± 161.4。结论上颌结节是骨连续性的最早证据。

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引用次数: 0

A case of adenocarcinoma, not otherwise specified arising at the sublingual gland 舌下腺腺癌1例，未作特殊说明

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology

Pub Date : 2025-08-12 DOI: 10.1016/j.ajoms.2025.08.006

Yuzo Abe, Yoshiro Saito, Takuma Morita, Yoto Imano, Ryogo Katada, Seigo Ohba, Toshikazu Shimane

Adenocarcinoma, not otherwise specified (NOS), is a malignant tumor occurring in the salivary glands without any histologically specific features of other salivary gland tumors. The incidence of adenocarcinoma NOS accounts for 16.8 % of all salivary gland malignant tumors, with the parotid gland being the most frequent site and only 1 % occurring in the sublingual gland. Here, we report a case of adenocarcinoma NOS arising in the sublingual gland. A 72-year-old Japanese male presented with a rapidly growing mass on the right side of the oral floor and underwent surgical treatment followed by adjuvant radiotherapy. The tumor was histopathologically diagnosed as high-grade adenocarcinoma NOS. No recurrence or metastasis was observed for 2 years after treatment.

腺癌是一种发生在唾液腺的恶性肿瘤，没有其他唾液腺肿瘤的组织学特异性特征。腺癌NOS的发病率占所有唾液腺恶性肿瘤的16.8 %，其中腮腺是最常见的部位，仅1 %发生在舌下腺。在此，我们报告一例发生于舌下腺的腺癌。一位72岁的日本男性在口腔底部右侧出现了一个快速增长的肿块，并接受了手术治疗和辅助放疗。经组织病理学诊断为高级别腺癌NOS，治疗后2年未见复发和转移。

引用次数: 0

Metastatic ALK fusion gene-positive lung adenocarcinoma in the mandible with numb chin syndrome as an initial manifestation 转移性ALK融合基因阳性的下颌骨肺腺癌以麻木下巴综合征为初始表现

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology

Pub Date : 2025-08-11 DOI: 10.1016/j.ajoms.2025.08.004

Rei Suzuki , Kenichiro Uchida , Ryo Nonaka , Kento Noda , Yoshiaki Kato , Hiroki Suda , Katsuaki Mishima

Numb chin syndrome (NCS) refers to abnormal sensations caused by injury of the inferior alveolar nerve. Causes are often metastatic mandibular tumors and the prognosis is usually poor. We report the case of a 76-year-old man with NCS as a first symptom of metastatic anaplastic lymphoma kinase (ALK) fusion gene-positive lung adenocarcinoma. Initially, metastatic adenocarcinoma was identified as the cause of NCS by a biopsy. Additional tumors were detected in the lungs, liver, and multiple bone sites by imaging. Immunohistochemical analysis of a biopsy sample revealed positive results for cytokeratin (CK)7 and thyroid transcription factor 1 and negative results for CK20. This result suggested the mandibular adenocarcinoma was a metastatic lung tumor. The metastatic tumor showed positive results on break apart analysis of the ALK gene in fluorescent in situ hybridization. Denosumab and alectinib were administered and the patient has survived 8 years without evidence of lung cancer progression.

颏麻木综合征是指因下肺泡神经损伤而引起的感觉异常。原因通常是转移性下颌肿瘤，预后通常较差。我们报告一例76岁男性的NCS作为转移性间变性淋巴瘤激酶（ALK）融合基因阳性肺腺癌的第一症状。最初，转移性腺癌被活检确定为NCS的病因。在肺部、肝脏和多个骨骼部位的影像学检查中发现了额外的肿瘤。活检样本的免疫组化分析显示细胞角蛋白（CK）7和甲状腺转录因子1阳性，CK20阴性。提示下颌骨腺癌为转移性肺肿瘤。荧光原位杂交对转移瘤的ALK基因进行分离分析，结果为阳性。给予Denosumab和alectinib，患者存活了8年，没有肺癌进展的证据。

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引用次数: 0

Desmoplastic ameloblastoma arising in the maxilla where it was difficult to determine the extent of resection: Significance of MRI diagnosis – A case report and updated literature review 上颌骨发生难以确定切除范围的成釉细胞瘤：MRI诊断的意义- 1例报告及最新文献综述

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology

Pub Date : 2025-08-10 DOI: 10.1016/j.ajoms.2025.08.003

Satoshi Shimohama , Manabu Yamada , Yuta Yasui , Masafumi Nishikawa , Kenichiro Suga , Seiji Asoda

Desmoplastic ameloblastoma (DA) is a histological subtype of "Ameloblastoma, conventional”, accounting for approximately 4–13 % of ameloblastoma cases. DA is associated with a high rate of local recurrence due to tumor infiltration into the adjacent healthy bone trabeculae. Additionally, radiographic findings typically demonstrate a mixed image of unclear boundary radiolucency and radiopacity, often complicating determination of the surgical resection margin. We herein report our experience with DA, where determining the extent of resection is difficult, and provide an updated review of the relevant literature. A 62-year-old male who presented to our department for further evaluation and treatment of a left maxillary anterior lesion. Computed tomography (CT) revealed a mixed image of unclear boundary radiolucency and radiopacity from the left maxillary anterior to the premolar region. The molar region showed a clearly demarcated radiolucency. A three-dimensional image analysis of CT showed no continuity between the two lesions, but magnetic resonance imaging (MRI) showed slightly heterogeneous contrast enhancement in both lesions. Biopsy confirmed the diagnosis of DA, and the patient subsequently underwent partial resection of the maxilla, including both lesions. A histopathological examination revealed DA in both lesions, and tumor microinvasion in the normal bone trabeculae connecting them. The surgical margins were negative. The patient is currently 17 months postoperatively with no signs of recurrence and a favorable clinical course. In the case of DA, which exhibits a greater tendency for invasion than conventional ameloblastomas, utilizing various modalities to determine the extent of resection enables appropriate resection, including a safety margin.

成釉细胞瘤（DA）是“常规成釉细胞瘤”的一种组织学亚型，约占成釉细胞瘤病例的4 - 13% 。DA与肿瘤浸润邻近健康骨小梁引起的高局部复发率相关。此外，影像学表现通常表现为边界透光度不清和放射不透明的混合图像，这通常使手术切除边缘的确定复杂化。我们在此报告我们对DA的经验，其中确定切除程度是困难的，并提供相关文献的最新综述。一名62岁男性，因左上颌前病变到我科接受进一步评估和治疗。计算机断层扫描（CT）显示左上颌前牙至前磨牙区边界透光不清和不透明。磨牙区有清晰的辐射透光度。CT三维图像分析显示两个病变之间没有连续性，但磁共振成像（MRI）显示两个病变的对比度略有不均匀增强。活检证实了DA的诊断，患者随后接受了上颌部分切除术，包括两个病变。组织病理学检查显示两个病变均有DA，连接它们的正常骨小梁有肿瘤微侵。手术切缘为阴性。患者术后17个月无复发迹象，临床病程良好。DA比常规成釉细胞瘤更容易发生侵袭，因此采用多种方法确定切除范围，包括安全范围。

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引用次数: 0

Posterior medial extension osteochondroma of mandibular head causing hearing loss 下颌骨后内侧伸骨软骨瘤引起听力损失

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology

Pub Date : 2025-08-10 DOI: 10.1016/j.ajoms.2025.08.002

Hiroki Taniguchi , Tadashi Chida , Ryuhei Yamada , Daiki Hirai , Ryoga Utsunomiya , Ryosuke Kawamura , Ryo Otani , Haruka Akiyama , Marimo Ichikawa , Osamu Ishihara

Osteochondroma is a benign bone tumor that often presents with malocclusion and facial asymmetry when it occurs in the mandibular condyle. We report a rare case of a female patient in her 80s with an osteochondroma of the right mandibular condyle extending posteromedially, compressing and narrowing the external auditory canal (EAC), resulting in conductive hearing loss. She underwent resection of the mandibular condyle, resulting in EAC decompression and subjective improvement in hearing. The unusual growth pattern of the tumor in this case likely contributed to the absence of typical symptoms, resulting in a delayed diagnosis. A literature review revealed that tumors that cause EAC stenosis often exhibit posteromedial growth, indicating a unique growth pattern. When evaluating hearing loss in the older population, tumorous lesions in the maxillofacial region should be considered in the differential diagnosis in addition to age-related changes.

骨软骨瘤是一种良性骨肿瘤，当它发生在下颌髁时，通常表现为错颌和面部不对称。我们报告一例罕见的80多岁女性患者，右下颌髁骨软骨瘤向后内侧延伸，压迫和狭窄外耳道（EAC），导致传导性听力损失。她接受了下颌髁切除术，导致EAC减压和主观听力改善。本病例中肿瘤的异常生长模式可能导致缺乏典型症状，导致诊断延迟。文献回顾显示，导致EAC狭窄的肿瘤通常表现为内侧后生长，表明其独特的生长模式。在评估老年人群的听力损失时，除了与年龄相关的变化外，还应考虑颌面部区域的肿瘤病变作为鉴别诊断。

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引用次数: 0