Eduardo Luis de Souza Cruz1, Ana Karla da Silva Tabosa2, Aline Semblano Carreira Falcão3, Talita Tartari4, Lucas Machado de Menezes5, Edmar Tavares da Costa6, José Thiers Carneiro Júnior7. 1. Resident of Oral and Maxillofacial Surgery at Ophir Loyola Hospital, Avenida Governador Magalhães Barata, 992, Belém, PA, 66063-240, Brazil. 2. Ophir Loyola Hospital, Avenida Governador Magalhães Barata, 992, Belém, PA, 66063-240, Brazil. 3. Evandro Chagas Institute, Rodovia BR-316 Km 7 s/n, Levilândia, Ananindeua, PA, 67030-000, Brazil. 4. Bauru School of Dentistry, University of São Paulo- FOB-USP, Vila Nova, Cidade Universitária, Bauru, SP, 17012901, Brazil. 5. Oral and Maxillofacial Surgeon of Ophir Loyola Hospital, Avenida Governador Magalhães Barata, 992, Belém, PA, 66063-240, Brazil. 6. Laboratory of Experimental Neuropatology, Barros Barreto Hospital, Federal University of Pará-UFPA, Rua dos Mundurucus, 4487, Guamá, PA, 66073-000, Brazil. 7. Oral and Maxillofacial Surgeon of Ophir Loyola Hospital, Avenida Governador Magalhães Barata, 992, Belém, PA, 66063-240, Brazil. drthiers@hotmail.com.
Abstract
PURPOSE: Keratocystic odontogenic tumor (KCOT) is an aggressive benign tumor and the management by complete enucleation followed by cryotherapy maintains the inorganic bone matrix, resulting in better repair and reduces the rates of recurrence. A refrigerant spray with a propane/butane/isobutane gas mixture has been pointed to as an alternative to liquid nitrogen, because the device is easy to handle and contain within the cavity, providing better control and lower risk of injury to the adjacent soft tissue. Thus, the aim of this study was to evaluate the outcome of enucleation followed by cryosurgery using a refrigerant spray of this gas mixture in ten patients diagnosed with KCOT. METHOD: The biggest lesions received a prior treatment consisting of marsupialization to decrease the tumor size. During the surgeries, the lesions were removed by enucleation and the surgical site was sprayed with the gas mixture. RESULTS: Wound dehiscence was observed in all cases, which healed by the second intention. The mean follow-up period was 64.3 months (range 24-120 months). Eight of the ten patients showed no evidence of clinical or radiographic recurrence. Pathologic fractures and infections were not observed. CONCLUSIONS: The results obtained suggest that enucleation followed by cryosurgery is an effective therapy for managing KCOT.
PURPOSE:Keratocystic odontogenic tumor (KCOT) is an aggressive benign tumor and the management by complete enucleation followed by cryotherapy maintains the inorganic bone matrix, resulting in better repair and reduces the rates of recurrence. A refrigerant spray with a propane/butane/isobutane gas mixture has been pointed to as an alternative to liquid nitrogen, because the device is easy to handle and contain within the cavity, providing better control and lower risk of injury to the adjacent soft tissue. Thus, the aim of this study was to evaluate the outcome of enucleation followed by cryosurgery using a refrigerant spray of this gas mixture in ten patients diagnosed with KCOT. METHOD: The biggest lesions received a prior treatment consisting of marsupialization to decrease the tumor size. During the surgeries, the lesions were removed by enucleation and the surgical site was sprayed with the gas mixture. RESULTS: Wound dehiscence was observed in all cases, which healed by the second intention. The mean follow-up period was 64.3 months (range 24-120 months). Eight of the ten patients showed no evidence of clinical or radiographic recurrence. Pathologic fractures and infections were not observed. CONCLUSIONS: The results obtained suggest that enucleation followed by cryosurgery is an effective therapy for managing KCOT.
Authors: Jason E Dashow; Jonathan B McHugh; Thomas M Braun; Sean P Edwards; Joseph I Helman; Brent B Ward Journal: J Oral Maxillofac Surg Date: 2015-05-20 Impact factor: 1.895
Authors: José Thiers Carneiro; Ana Paula Guerreiro Rodrigues Couto; Aline Semblano Dias Carreira Journal: J Craniomaxillofac Surg Date: 2012-03-13 Impact factor: 2.078
Authors: H Myoung; S P Hong; S D Hong; J I Lee; C Y Lim; P H Choung; J H Lee; J Y Choi; B M Seo; M J Kim Journal: Oral Surg Oral Med Oral Pathol Oral Radiol Endod Date: 2001-03